长寿、医疗保健与政府在科技创新中的角色

有些工作会消失。我是说，每次技术革命都会这样，很多工作只是换种方式完成。还会创造出各种新工作。你知道，大型技术革命之后总是很快就会出现这种情况。当你思考这个问题时，特别是围绕人类、医疗、长寿以及我们本质上如何生存下去，这些都掌握在极少数人手中，而且全是私有的。政府如何更多地参与进来？因为它们不再像过去那样参与科学研究和互联网的起步了。我们多次说过，在一个运转良好的社会里，OpenAI 本该是政府的一个项目。我也可以说其他很多行业也是如此。你如何帮助解决这个问题？因为你们都已经进入了这个领域，对吧？我的意思是，很多人会说，‘哦，你对科技人士生气了吗？’我会说，‘他们就是这样做的。他们进入各个领域。是政府放弃了它的责任。’政府应该做 AI 研究。政府应该做长寿研究，并让这些成果惠及大众。政府应该解决核聚变问题。

Some jobs will go away. I mean, they do with every technological revolution, many jobs will just be done differently. There will be all kinds of new jobs created. You know, it's always pretty quickly after the big technological revolution. When you think about this, especially around humanity and healthcare and longevity and us surviving on existence essentially, it's in the hands of very few people and it's all private. How does government get more involved because they just aren't in the way they used to be involved in science research and the beginning of the internet? We have said many times that in a well functioning society, OpenAI would have been a government effort. I could say that about a lot of other industries too. How do you help fix that? Because you've all moved into the space, right? I mean a lot of people are like, 'Oh, are you mad at the tech people?' I'm like, 'That's what they do. They move into spaces. It's the government that's abrogated its responsibility.' The government should be doing the AI research. The government should be doing the longevity stuff and making those things available. The government should be figuring out fusion.

你大部分时间都在做关于 OpenAI 和其他事情的采访。我们来谈谈你感兴趣的另一个领域。你和我聊过你对能源和各种不同事物的兴趣，我觉得人们不太了解这部分，那就是长寿。我希望你定义一下你现在感兴趣的是什么，以及你这次的投资理论是怎样的。具体到长寿，我会说更广泛的类别是对医疗健康的兴趣。我之所以对长寿感兴趣有很多原因，但我记得有人说过，大多数疾病都是年龄相关的疾病。你知道，20 岁的人远没有 80 岁的人那么容易生病。所以如果我们能解决这个通用问题，也许就能全面改善医疗健康结果。我对长寿有过一段时间的兴趣，但当部分重编程的发现开始出现时——请给人们解释一下那是什么。这个想法是，我们可以让细胞年龄稍微倒退一点，不是完全回到干细胞状态——你不想变回一团浆糊——而是让细胞变得年轻一点，对吧？这看起来是一个非常令人兴奋的发现，我最终对一家名为 Retro 的公司进行了大笔投资，以追求这一目标。

You mostly do interviews about OpenAI and other things. We're going to talk about another area that you're interested in. And you and I have talked about you're interested in energy and all kinds of different things which I think people don't know much about this part which is longevity. I want you to define what you think you're interested in right now and the way your investment theory is going on this time. For longevity specifically, I'd say that the broader category is an interest in healthcare. And I'm interested in longevity for a bunch of reasons, but I remember once someone saying that most diseases are diseases of age. You know, 20-year-olds don't get nearly as sick as 80-year-olds. And so if we can figure out the general purpose thing here, maybe we can improve healthcare outcomes across the board. I had a passing interest in longevity for a long time and then when the partial reprogramming discoveries began to happen, explain what that is for people. The idea that we could sort of rewind a cellular age a little bit, not all the way back to a stem cell, which you don't want to be turned back into goo, but we could make your cells a little bit younger, right? So that seemed like a kind of crazy exciting discovery and I ended up making a large investment in a company called Retro to pursue that.

这个兴趣从何而来？是你想活得更久，还是什么？或者你对科幻感兴趣？

And where did it come from? Where did this interest? Was it you wanted to live longer or what was it? Or were you interested in sci-fi or what?

我想是以上所有原因。我对医疗健康非常感兴趣，而且——我认为我对创业和技术的整体方法是，我们能否找出某个问题的关键所在。对于医疗健康，如果我们能真正让你在健康方面保持更长时间的年轻，那将解决很多健康问题。所以与其一个接一个地对抗疾病和问题，也许这就像我们可以一刀斩断的戈尔迪之结。这个想法是，医疗健康的大部分成本都出现在生命末期，而且生活质量的大部分下降也发生在那个时候，对吧？基本上就是活得不好。

I think kind of all of the above. I was really interested in healthcare and is there like a—I think my whole kind of approach to startups and technology is can we identify the crux issue for something. And then for healthcare, if we could truly keep you health-wise younger for much longer, that would address a lot of the health issues. So rather than try to fight disease after disease and problem after problem, maybe this was like the Gordian knot we could cut through all. So the idea is most of the costs come at the end of your life in healthcare, but also just most of the degradations in quality of life, right? And living badly essentially.

你自己害怕吗？因为有一种说法——你知道硅谷那些人想长生不老、自恋等等的说法。有很多这样的例子。你可以看到布莱恩·约翰逊之类的。所有这些都隐约有些自私，并且受科幻启发，想变成机器人、半机械人等等。这不是你的风格吧？至少不是有意识的。

Were you yourself scared of that because there is this sort of trope of you—you realize the trope of Silicon Valley guys wanting to live forever, narcissism, etc. And there's a lot of examples of that. You can see Brian Johnson, whatever. All of it is vaguely selfish and sci-fi inspired in some fashion of becoming a robot, becoming a cyborg, etc. Is that not your thing? At least not consciously.

不，我不认为像 Retro 这样的技术能让你永生。没错。我认为你会更健康地活得更久，然后急剧下降。所以你只是更健康地活得更久，而不是永生。我当然不想长时间病得很重。

No, I don't think a technology like Retro will make you live forever. That's correct. I think you'll be healthier for longer and then a very steep. So you just have healthier for longer, not live forever. I definitely don't want to get really sick for a long time.

那么，解释一下 Retro 在做什么，以及你为什么选择这家公司，因为现在有很多人在做这方面的事情。

So, explain what Retro is doing and why you picked that particular company because there's lots of people sort of hitting this from—there are a lot of things now.

当时还没有那么多。这个部分重编程的广泛领域在我看来在实验室里非常有前景。这是我认为少数几个可能真正在整个人身上起作用的方法之一。而且似乎值得追求。我对学术界把事情做成的能力越来越悲观。我认为学术界在某些方面仍然非常出色，比如早期发现，但如果我们真的想把这个想法变成能真正帮助人们的东西，也许创业公司是个好主意，对吧？这听起来像个真正的硅谷人。我显然有自己的偏见，但有时这确实管用。太空旅行，一切。有时管用。目标是增加 10 年的健康寿命。所以也许它根本不会让你活得更久，但你会更健康地活得更久。我个人最兴奋的方法是给你一些蛋白质、一些 RNA 或 DNA 来表达这些蛋白质，不管是什么，但以某种方式对你的细胞进行处理，使它们部分重编程回到更年轻的状态。

At the time, there were not as many. This broad area of partial reprogramming seemed to me like the kind of thing that looked incredibly promising in the lab. It was one of the few approaches that I thought could really work across a whole person. And seemed worth pursuing. I have become increasingly negative on the ability for academia to make things happen. I think academia is still really great at some things, early discovery, but if we really want to take this idea and maybe make it into something that can really help people, maybe a startup is a good idea, right? Which spoken like a true Silicon Valley person. I have my bias obviously, but sometimes it works. Space travel, everything. Sometimes it works. The goal is add 10 years of health span. So maybe it doesn't keep you alive any longer at all, but you're healthier for longer. And the approach that I am personally most excited about is to give you some proteins, some RNA or DNA that will express those proteins, whatever it is, but somehow do something to your cells that will partially reprogram them back to a younger state.

我们采访过的很多人都指出，AI 是癌症研究等各种领域的重要工具。谈谈 OpenAI 和 AI 总体上将扮演的角色。

A lot of people we've talked to are all pointing to AI as an important tool in whether it's cancer research, whether it's all kinds of whoever is doing approaching these things. Talk a little bit about the role that something like OpenAI and AI in general will have.

医疗是 ChatGPT 最大的用途之一，在 GPT-5 中我们大力提升了它在医疗方面的能力。人们经常用它来了解自己的健康状况，上传病历，询问症状相关问题。网上有很多故事讲人们如何用它在非常重要的方面，我们当然认为这很棒。所以 GPT-5 我们重点提升了它在健康相关查询上的表现。

It's one of the healthcare is one of the biggest uses of ChatGPT, and with GPT-5 we made a big push to improve it for healthcare. People use it to understand their health all the time. They upload their medical records. They ask questions about symptoms. You can read a lot of stories on the internet about people using this in super important ways, and obviously we think that's great. So with GPT-5 we did a big push to make it better at health-related queries.

那么当你思考这些用途——患者的使用、医生的使用——十年后会是什么样？我听过很多医生和医疗工作者说，他们希望十年后每个人都能获得比今天任何人能获得的最好医疗还要好的医疗。他们想象一个世界，你可以从一个 AI 医疗顾问服务开始，你说'我遇到了什么问题'或者'这是我的日常生活'，提供你的睡眠数据、饮食、血液检查、症状。然后服务可以早期就说：'嘿，你有这个风险，需要去检查这个，需要做出这个改变，需要去看这个专科医生。这个有点奇怪，你需要去这里。'

So when you think about that uses that's patient uses doctor's uses in 10 years what could it be? I've heard a lot of doctors and healthcare workers say that, you know, they hope that in 10 years everybody gets and they think this they literally mean this everybody gets better healthcare than the best healthcare anyone can get today. You know, they imagine a world where you can start with an AI medical advisor service and you can say here's what's going on for me or hey, I'm just this is my normal life. Here's my sleep data, what I'm eating, my blood tests, my symptoms. And you know, a service could early on say, 'Hey, you're at risk of this. You need to go test for this. You need to make this change. You need to go to this specialist doctor. This is a little weird. You need to go here.'

前几天我做了件听起来很疯狂的事。我用 ChatGPT，我手上有个东西，我想'这是什么？疣？'我拍了张照片。它真的识别出来了。我穿过了一片荆棘丛，但我忘了。它说'你是不是穿过荆棘丛了？'我说'是的'，然后它说那就是那个样子。这挺有意思的，结果很好，对吧？

The other day I had a Sounds crazy. I used ChatGPT for this. I had a thing on my hand. I'm like, 'What is it? A wart? What is it?' I took a picture. Picture what it was. It really did. It was I had gone through a pricker bush and I had forgotten I had done that. And it's like it said, 'Did you go to a pricker bush?' And I said, 'I did go through a pricker bush' and you know and I said that's what it looks like. Which was interesting. Which was a good outcome, right?

谈谈你担心的事情吧，因为有很多事情。有很多失控的故事。最近有个故事，一个孩子用 ChatGPT 导致了悲剧。你在微调这个东西的时候担心什么？

Talk a little bit about the things you're worried about because you know there's a lot of things. There's a lot of stories of things that get out of control. You recently had a story of a kid who was using ChatGPT to tragic effects. What are the things you worry about when you're trying to fine-tune this?

总体而言，心理健康是我越来越担心 AI 会影响的领域。再次强调，我认为它可以带来巨大的好处。但这一切发生得太快了，ChatGPT 才刚过三年左右。第一年它被当作一种新奇事物，可能有点替代谷歌，或者写写学校论文。直到最近的进化，人们才开始把它用作人生教练、某种治疗师、亲密顾问之类的。我们了解到很多人需要有人倾诉和给出建议。我担心的是，鉴于发展如此之快，社会层面的行为可能会发生变化，从而影响社会层面的心理健康。我们正在非常努力地掌握情况并理解发生了什么。但这确实是我担心的事情。

Mental health in general is something that I'm increasingly worried about with AI. Again, I think it can be done for tremendous good. But this is happening very fast, you know, like I think ChatGPT is a little bit more than or coming up on three years old, right? And for the first year it was used as a sort of curiosity, maybe a Google replacement a little bit, right? Maybe like, you know, write my essay for school or whatever. Only with more recent evolutions did people start to use it as a life coach, sort of a therapist and you know close advisor, things like that. We have learned that a lot of people need someone to talk to and to give them advice. And I am worried that given how quickly this is moving that societal scale behavior could change in a way that affects societal scale mental health. And we are working super hard to get a handle on that and understand what's happening. But it is something I'm worried about.

所以你为此聘请了 250 名医生。大多数人跟我谈 AI 对医疗、寿命等影响时，都说必须有人类元素。在很多方面，你几乎想消除人类。不，它倾向于那样。但我很确定，即使人们知道人类医生表现不如 AI 医生，他们还是会明显更喜欢人类医生。我当然也会。我希望我的医生使用所有这些工具，我自己也会用。但有一种很深的东西——我没有太多严重健康问题，但当我确实有时，我真的不愿意把命运交给 AI。我非常在乎那个人类医生和他们的人性。

So you engage 250 doctors in doing this. One of the things most people tell me when they're talking about AI's impact on healthcare, longevity, everything else is there has to be that human element. In a lot of ways, it you almost want to eliminate the human in it. No, it tends towards that way. I am pretty sure though that people even if they know the human doctor is going to perform worse than the AI doctor will significantly prefer the human doctor. I certainly would. I want my doctor to use all these tools. I want to use these tools myself. But there is like something very deep of have not had that many serious health issues but when I did have one I really would not have been happy like leaving my fate in the hands of an AI. I really cared about that human doctor and their humanness.

部分原因是出于对医疗系统的沮丧，甚至连预约都很困难。无论你处于哪个经济阶层，除非你非常富有，否则很难请到医生。大多数人都很难获得医疗服务。

Some of it's driven by a frustration with healthcare, of course, the difficulty of making even an appointment. No matter where you are on the economic scale, unless you're very rich, you can invite the doctors in. Most people have difficulty getting care.

假设我得了严重的毒葛。我拍了张照片发给 ChatGPT，它说'你得了毒葛'。我说'有道理，我前几天去徒步了，那些是暴露的部位。我觉得你说得对，我很不舒服。'它说'你想要泼尼松的处方吗？我确定就是这个问题。'我会说'太好了'，我对此很放心。另一方面，如果我有一些非常奇怪的症状，AI 说'那可能是癌症，你最好去看医生'，我肯定会想办法预约，真的很想和医生谈谈。

Let's say I got like bad poison oak. And I took a picture and I sent it to ChatGPT and I was like, 'It says you have poison oak.' And I said, 'That makes sense. I was hiking the other day. Like those are the exposed areas. I think you're right. I'm really uncomfortable.' and it's like, 'Would you like a prescription for prednisone? I'm sure this is your problem.' I would say, 'Great.' Yeah, I'm comfortable with that. On the other hand, if I have like some really weird symptoms and an AI says, 'That could be cancer. You better go see a doctor.' I will definitely go figure out a way to get that appointment and really want to go talk to a doctor.

GPT-5 是第一次出现真正微小但真实的例子。给我举个例子。

GPT-5 is the first time where there have been real small but real examples of this. Give me an example.

几天前我在推特上看到一个数学证明，然后有人说也许我们可以做得更好，让 GPT-5 Pro 来研究一下，结果它提出了一个新颖且更好的解决方案。所以它开始能做小的发现了，但真正有用的、人类做不到的实际发现。或者人类没做过、计算机至今也没做过的。

There was like a I saw on Twitter a couple of days ago there was like a math proof and then someone said maybe we can do a little bit better and ask GPT-5 Pro to work on it and came up with a novel and better solution. So it could do little discoveries starting to but a real useful like actual discovery that humans couldn't do. Yeah. Or hadn't done or computers to this point hadn't done.

所以你说到 2035 年，你预计 AI 将能够治愈或至少治疗大多数疾病，真正减轻一些人的痛苦。是的。治疗或减轻之类的。但我想我们——再说一次，这个与 Retro 的研究项目就是一个例子，它把我们的研究推进了好几年。我主要得听生物学家和制药公司怎么说，这远远超出了我的专业领域。所以你说的就是压缩时间，或者发现新见解。两者都有：加速新见解的发现速度，以及产生见解本身。

So you said by 2035 you anticipate AI will be able to cure or cure at least treat most diseases really mitigate some people. Yeah. Treat mitigate something like that. Right. Right. But I think we are I mean again this research project with retro is one example where it's like wow this is like this just pushed us years ahead in our research and I have to mostly go with what the biologists and the pharma companies say here. This is way out of my field of expertise. So this is squeezing time is what you're talking about or finding new insights. Both speeding up the rate of discovery of new insights and then making the insights themselves.

现在，关于 2035 年那个说法，我听到专家们说那是他们认为我们搞明白它是什么的时候，那真正应用到临床需要多久？人们觉得情况越来越糟。有一件事很不可思议：过了这么久，我们对人类生物学仍然知之甚少，尤其是大脑。谈谈超级智能如何克服这一点。

Now, that quote about 2035 that I heard people experts say that's when they think we know what it is, how long it takes to actually get that into the clinic? There people are like that's getting worse and worse. One of the things is incredible after all this time we know very little about human biology, especially the brain for example. Talk about how superintelligence overcomes that.

我们并不那么聪明，而生物学极其复杂。我们可以想象任何东西。我们可以让别人把极其复杂的事情解释给我们听，然后我们就能理解。但要发现这些东西需要大量的脑力，在很多情况下可能超出了我们的能力。如果一个比我们聪明一千倍或一百万倍的智能能够真正弄清楚这一切是如何运作的，然后解释给我们听，我相信我们能够理解，即使它最初复杂到我们无法自己搞明白。

We are not that smart and biology is enormously complex. We can imagine kind of anything. We can have someone explain enormously complex things to us and then we can get it. But to discover these things requires a lot of brain power and in many cases maybe more than we have. If an intelligence, you know, a thousand times or a million times smarter than us can figure out really how all of this works and then explain it to us, I believe we'll be able to understand it even if it was too complex for us to figure out in the first place.

是的。所以它会给我们答案。

Yes. So it will give us the answer.

是的。然后我们会说，‘哦，对。’你和我都能理解非常复杂的物理学，但要让比我们更聪明的人花上一辈子才能搞明白。

Yes. And then we'll go, 'Oh, right.' You and I can understand very complex physics, but it would have taken lifetimes of smarter people than us to figure it out.

你也能理解复杂的东西。前几天我和儿子吃午饭，他试着解释，但那是浪费时间，我们就转到超级智能了，我很想试着解释一下。是的，我明白你的意思。我有个血液问题，白细胞低，医生诊断为中性粒细胞减少症，意思就是白细胞低。那是一个描述，不是解释或诊断。我就问，为什么？嗯，因为白细胞低。我就说，但那不是答案，那是描述。这就是医学界经常用描述来掩盖诊断的地方。我记得我站在一个护士面前，她说：‘哦，很多刚生完孩子的女性都有这个。’我说：‘真的吗？’她说：‘是的，我见过很多。’但那只是她记忆中的东西。我往她身后看，那里有一叠一叠的病人资料。我想：‘答案就在那里某个地方。’

You could understand complex, too. I had lunch with my son the other day and he's tried to and it was a waste of time and we moved on to the super I'd love to take a crack at explaining it. Yeah, I get what you mean. I had a blood thing where I have low white blood cells and doctors diagnosed it as neutropenia which means low white blood cells. That was a description, not an explanation or a diagnosis. And I was like, well, why? Well, because it's low white blood cells. And I was like, but that's like there's that's not an answer. It's description. And that's where medical people often hide behind a description versus a diagnosis. And I remember looking standing in front of a nurse and she said, 'Oh, a lot of women who just had babies have this.' And I was like, 'Really?' She goes, 'Yeah, I've seen a lot.' But it was in her head from memory. And I looked behind her and there was sheets and sheets of paper of all the patients. And I thought, 'The answer is in there somewhere.'

就在那里某个地方。是的。我认为我们肯定能做到的是真正赋予个人能力，让他们能够为自己争取更好的结果。

Is in there somewhere. Yeah. What I think we can do for sure is really empower individual people to be able to advocate for better outcomes for themselves.

你觉得接受这些技术的障碍在哪里？是医疗界，还是制药公司？我本以为制药公司会拥抱它，这样他们可以更快地发现药物。

Where do you find the problem in accepting these technologies? Is it the medical, is it pharmaceutical companies? I would think pharmaceutical companies would embrace it so they can do drug discovery faster.

我们没有看到医疗界像人们告诉我们的那样排斥。事实上，每次我去诊所或医院之类的地方，他们都会问，你知道，我们这边怎么样，他们就说，别告诉别人，但这里的每个医生都在用这个，我们只是在家用，你知道，请做一个符合 HIPAA 的版本，这样我们就能在工作时用了，但我们都很喜欢。

We have not seen the kind of rejection from the medical community that people told us we were going to get. In fact, every time I go visit like a clinic or a hospital or whatever, they're and I'm kind of asked, I'm like, you know, how's it going with us, whatever, they're like, don't tell anyone, but every doctor here uses this all the time and we just do it at home and, you know, please make a HIPAA compliant version so we can do it at work, but we all like we all love it.

当你考虑延长寿命时，你说的是把信息的力量交到人们手中。这是如何运作的？你认为除了检测之外，它对医疗保健和长寿有影响吗？

When you think about extending longevity, you're saying you're giving power information in the hands of people. How does that work? Do you think it has an implication on healthcare and on longevity besides detection?

是的，我认为这些有点不同。我的意思是，我们一直在讨论的主要是让消费者能够获得好的医疗信息，这更多是关于他们自己的理论性东西。而实际上人们已经在做了，很多人每天都在做。嗯。然后还有另一类问题：我们能否用 AI 来更好地进行长寿研究，与任何正在研究它的公司或方法合作？我认为这两者非常不同。我的意思是，同样的智能对两者都很重要。所以 AI 对两者都有效，但方法截然不同。

Yeah, I think these are like somewhat different. I mean, I think that what we've been talking about mostly is giving consumers access to like healthcare good information is one thing about themselves in particular like a theoretical thing. This is like here people do it. A lot of people do it every day. Mhm. And then there's this other category of can we use AI to do better longevity research with any of the companies or approaches that are working on it and I think those are pretty different. I mean the same intelligence matters for both of them. So AI will work for both of them but they're quite different approaches.

人们——消费者、病人——太希望它有效了，以至于吸引了骗子，他们赚了很多钱，因为人们什么都愿意试，对吧？你知道，越疯狂越好。我觉得这显然很令人反感。这说明人们多么渴望某样东西，你知道吗？就像每个人都想要一颗神奇药丸。你告诉人们每晚睡八小时、锻炼、合理饮食、少喝酒，他们就说：‘不，我才不干那些。我要一颗药丸。’嗯，所以在寻找这种作弊码的过程中，人们吃各种疯狂的东西，几乎没有医学证据。你也会上当吗？到了这个地步，很难不上当，对吧？

People want like consumers patients want it to work so badly that it attracts charlatans and they make a lot of money cuz people will try anything right? you know, whatever. The crazier the better. It sounds like and you So, I find that obviously really distasteful. It speaks to how much people want something, you know? It's like everybody wants a magic pill. You tell people like sleep eight hours a night, get exercise, eat reasonably healthy, and don't drink so much. They're like, 'Nah, you. I'm not going to do any of that. I want a pill.' Um, and so in the in the like search for this cheat code, people take all kinds of crazy stuff. limited to no medical evidence. Do you fall prey to that? Do you At this point, it's hard not to, is it?

呃，我是说，到处都是。当 GLP-1 类药物刚出现时，很久以前，很多很多年前，对吧，有一家配药房可以为你配制。我当时不知道配药房是什么。呃，所以他们给我配了。嗯，他们搞错了剂量，我不记得具体数字了，但是一次超大剂量。是的。而且我以前从未服用过，所以完全没有耐受性之类的，对吧？我就像在某个周日注射了，大概是上午 11 点。下午 2 点、3 点开始感觉非常糟糕。我确信自己病得很重。那天晚上我有朋友来吃晚饭。我现在的丈夫看着我说：‘你快死了。’我不知道。他说：‘你有点疯狂，你快死了。’是的。我还没把这事联系起来。哦，哇。呃，我上床睡觉，感觉糟透了。嗯，吐了一整夜。不管怎样。我现在大概意识到可能和这个有关。也许嗯，我的脉搏大概 150 左右，血糖低得难以置信，早上完全崩溃，去了急诊室。是的。嗯，然后第二天，他们给了我一个谷歌试纸之类的东西。第二天我们大概搞清楚了，但你也做不了什么。

Uh, I mean, it's all around. When the GLP1s first came on the scene, long time ago, like many, many years ago, right, there was this uh compounding pharmacy that'll make it for you. I had no idea what a compounding pharmacy was. Uh, so they make it for me. Um, they screw up the dosing and I do I don't remember the exact number, but a mega overdose. Yeah. And I had never taken before, so I had like no tolerance or whatever, right? And I like injected like a, you know, it's like a Sunday or something. Let's call it 11:00 a.m. 2 p.m. 3 p.m. start feeling really bad. Convinced I'm like really sick. I have my friends over for dinner that night. My now husband looks at me. He's like, 'You're dying.' I don't know. You're like, 'You got some crazy you're dying.' Yeah. And I hadn't put it together that it was this yet. Oh, wow. And uh I I go to bed feeling horrible. Mhm. Puking all night. Whatever. I now have kind of put together that maybe it has to do with this. Maybe um and I uh you know my pulse is like 150 something like that like blood sugar unbelievably like just like fully crashing in the morning with the ER. Yeah. Um, and then like over the next day, they gave me like a Google strip, whatever. Over the next day, we kind of figure out, but there's nothing you can do.

你等着瞧吧。有趣且不为人知的一点是，它会让你没有食欲。吃够了，就会让你对其他任何东西都失去欲望。所以我花——我通常是个需要很多新东西来思考的人。

You just wait, right? An interesting and unknown thing about this is that it makes you not have a desire to eat. Take enough of it, it makes you have no desire for anything else. So, I spend—and I'm usually a very kind of person who needs a lot of new stuff to think about.

是的，我知道。我也是这样。

Yes, I know. I'm the same way.

我有那么几天躺在医院病床上，盯着白色天花板，对吧？什么都不想，不看手机，什么都不想要，对吧？感觉糟透了，对吧？但就是没有任何欲望，对吧？

And I had these few days lying in this hospital bed staring up at a white ceiling, right? Thinking nothing, not looking at my phone, not wanting anything, right? Feeling terrible, right? But just no desire for anything, right?

长寿的一个好处是每个人都会变老。嗯。所以那里有一个大众市场。你不用担心那部分。我确实认为，那些世界上只有两万人患有的疾病，如何让资本主义为此运作并不明显。我认为任何能增加 10 年健康寿命的东西，我们都能利用资本主义的好处让它变得便宜。我想这就是我会做的。

One thing that is better about longevity is everybody gets old. Mhm. And so there's a mass market there. You don't have to worry about that part. I do think these things where there's only, like, 20,000 people in the world that have a disease, it's not so obvious how to make capitalism work for this. I think anything that we could come up with that would add 10 years of health span, we'll have the benefits of capitalism to help us make it cheap. And I think that's what I would do.

你确实。你担心说，一定数量的富人——所有科幻小说都围绕富人拿走所有好东西？

You do. Are you worried about saying a certain amount of rich all the sci-fi is around the rich people taking all the goodies?

我的意思是，我更多考虑的是 AI 而非长寿的版本，但对于 AI，是的，这绝对必须解决。我认为我们现在实际上在相当广泛地分配 AI 的好处方面做得很好。但你可以想象一个不这样的世界。如果你有很多资本，并且全部投入你的 AI 大脑，那相对于没有的人就是巨大的优势。

I mean, the version of this I think about much more for AI than longevity, but for AI, yes, it absolutely has to be fixed. I think we're actually doing a really good job right now of distributing the benefits of AI quite broadly. But you can imagine a world where it doesn't go that way. And if you have a lot of capital and you put it all into your AI brain, that's like a huge advantage over people who don't.

OpenAI 有多少人专注于健康相关目标的时间研究？

How many people at OpenAI are focusing on time research on health-related goals?

我实际上不知道健康团队的规模。它不小，而且增长很快。然后我们还有科学研究团队。

I actually don't know the size of the health team. It's not tiny, but it's growing fast. And then we have the scientific research teams.

当然，其中一个抱怨是——而且不只是你——这在互联网早期就发生过。我记得很多公司说，‘我们在这里帮助人类。’而我想，‘不，你们不是。你们不是真的。’我过去总是引用《阴阳魔界》的剧集《服务人类》，外星人来帮助我们，然后他们本质上想吃掉我们。你如何反驳健康目标只是你其他事情的营销这种观点？

One of the complaints, of course, is that—and it's not just you—it happened early in the internet. I remember a lot of these companies saying, 'We're here to help humanity.' And I thought, 'No, you're not. You're not really.' And I always used to reference the Twilight Zone episode 'To Serve Man,' which was the aliens come to help us and then they want to eat us essentially. How do you push back against the idea that the health goals is just marketing for the other things you're doing?

我的意思是，再说一次，我打赌它现在是 ChatGPT 的前三大用例之一。这是一件重要的事情。公平地说，它只是我们的目标之一。我们也想帮助人们写更好的代码，我们想要一个更好的搜索引擎，我们想帮助人们更高效。我们也有它只是娱乐人们，等等。所以我们不是一家健康公司。它是众多事情之一，但它是人类体验的重要部分。

I mean, again, it's like I would bet it's a top three use case of ChatGPT at this point. Like it's a significant thing. It is fair that it's only one of our goals. Like we also want to help people write better code and we want to have a better kind of search engine and we want to help people be more productive. We also have it just entertain people, whatever. So it's like we're not a health company. It's one of many things, but it is a significant part of the human experience.

如果 AGI 出现，并且它被设计来帮助保护人类，让他们活得更久、做更好的事情。你最坏的情景和最好的情景是什么？假设它存在。

If AGI happens and it's designed to help protect humans and make them live longer and do better things. What is your worst scenario and what's your best scenario for, say, it exists? Let's just assume it exists.

我认为在所有这些情况下，人们对于是否将其视为工具还是生物感到困惑。我认为它就像一幅不可思议的罗夏墨迹测验，人们谈论它的方式更多地说明了他们自己，而不是 AI。显然没人知道，人们可以这样做，但你知道，如果你——我认为听人们说总是很有启发性。你怎么看？

I think in all of those cases, people are confused about whether they want to think about it as a tool or a creature. I think it's like this incredible Rorschach test, and the way people talk about it says much more about them than it has anything to say about AI. No one knows, obviously, and people can do it, but you know, if you're like—I think it's kind of always really revealing to hear people. How do you look at it?

我认为它是一个工具。我认为它会做惊人的事情，但它不会是科幻电影中那种有自我意识的东西。假设 OpenAI 的下一个 CEO 是一个 AI。你知道，我喜欢这样。我可以写提示，让那个 AI 去做什么。嗯。然后它可能会去做疯狂复杂的事情。在世界上看来，它可能像是在铺设这些高速公路，做各种事情。但仍然是某个人必须要求系统去完成某个目标。但归根结底是提示，对吧？

I think of it as this tool. Like I think of it as it's going to do amazing things, but it is not going to be this self-aware thing from the sci-fi movies. Let's say the next CEO of OpenAI is an AI. You know, I like it. I get to write the prompt for what I would like that AI to go off and do. Mhm. And it may then go do crazy complex things. It may look to the world like it's paving these highways and doing whatever. But it was still like some person had to ask the system to go accomplish some goal. But it comes down to the prompt, right?

是的。

Yeah.

再说一次，它可能在如此长的时间跨度内如此复杂，沿途有如此多的支线任务，以至于感觉与人类健康无关。它更大，关乎我们的存在，我们在地球上的实际存在。伦理能跟上正在发生的进步吗？

Now again, it could be so complex over such a long time horizon, so many side quests along the way that it doesn't feel like that having to do with human health. It is a bigger and our existence, our actual existence on the planet. Can ethics keep pace with the progress that is happening?

伦理已经落后了。我本来想说，我有一些希望 AI 能帮助我们想出更好的双赢系统。你知道，我认为世界上需要新想法。显然我们自己想不出来。所以那是我乐观的情况。乐观的是最终它会更好。

Ethics already runs behind. I was gonna say, I have some hope that AI will help us figure out better win-win systems. You know, I think we need new ideas in the world. And clearly we're not coming up with them on our own. So that'd be my positive case there. Positive that in the end it will be better.

是的。最终，有了这个工具帮助我们思考，我们会想出比没有它更好的伦理系统。正如你所说，提示很重要。首先被问的问题是什么，就像谷歌查询一样。当你想到医疗保健时，提示应该是什么？

Yeah. In the end that we will come up with better ethical systems with this tool helping us think than without. As you said, the prompt matters. What's the question that's being asked in the first place, just like a Google query. When you think about healthcare, what should the prompt be?

嗯，比医疗保健更广泛，尽管这非常契合，我认为大多数人想要的提示的某种版本是：帮助我根据我的目标蓬勃发展，无论这些目标是什么。也许帮我弄清楚它们，但一旦我弄清楚，帮助我根据我的目标在很长的时间跨度内蓬勃发展。嗯。那是精神上、身体上、一切方面的蓬勃发展。

Well, more generally than just healthcare, although this fits really well into this, I think the prompt that most people want some version of is: help me flourish in accordance with my goals, whatever those are. Maybe help me figure them out, but once I figure them out, help me flourish in accordance with my goals over a very long time horizon. Mhm. And that is flourish mentally, physically, everything.

既然你不用这些东西，我很想知道，你最近有没有听到关于长寿的疯狂事情，让你想说‘哦，别这样。’

Since you're not using any of these things, I'd love to know, have you heard of something recently that's been crazy around longevity that you're like, 'Oh, stop it.'

冰浴的人让我很烦。他们对此如此虔诚、自鸣得意。是的。就像他们很乐意告诉你，‘哦，我的冰浴是，你知道，36 度。我坐 45 分钟。’

The ice bath people are so annoying to me. They're so religious, smug about it. Yeah. Like they take such pleasure in telling you, 'Oh, my ice bath is, you know, 36 degrees. I sit in for 45.'

我的是 35 分钟。我坐够 50 分钟。他们深信不疑这有用。也许确实有用，但最近有项研究说没用。

Mine's 35. I sit in for 50. And they're so convinced it works. Maybe it does, but there was this study recently that it doesn't.

是啊。我刚把研究发给了那些吹嘘自己多痛苦的朋友。他们不喜欢。不是那些禁食的人。他们快把我逼疯了。硅谷有段时间，我不得不去参加有禁食者的晚宴，然后我就坐在那儿吃牛排或别的什么。

Yeah. And I just sent it to all these friends that brag about how miserable they are. They don't like it. Not the fasting people. They drove me crazy. There was a whole period in Silicon Valley where I had to go to dinner parties with fasting people and then I just sit there and eat the steak or whatever it happened to be.

你会把自己的大脑上传到智能里吗？我非常怀疑。我更关注坏处。我能看到很多可怕的方式。我可不想在模拟中被永远虐待。对吧。永远。

Would you upload your brain into the intelligence? I am very skeptical. I'm much more focused on the downside. I can see ways where that's horrible. I want to be mistreated in a simulation for all of eternity. Right. For all of eternity.

没错。是啊。那把你的大脑放进另一个身体呢？有个著名的桥段，外星人降临后说：‘为什么人类在用他们的肉片？’是个老电视剧。你想成为 AI 吗？想和 AI 融合吗？不，我喜欢我的身体。我喜欢这个世界。我不想把 AI 放进我的大脑。像《黑客帝国》那样的方案。有程度之分，对吧？某种版本下我会增强。突然就会弹钢琴之类的。但天哪，我会非常怀疑。

Right. Yeah. What about putting your brain into another being? There's a famous thing where aliens come down and they're like, 'Why are humans using their meat flaps?' It's an old teleplay. Would you like to just be an AI? Would you like to merge with an AI? No, I like my body. I like the world. I wouldn't want to put AI in my brain. A matrix-like solution. There are gradations, right? There's some version of that where I would augment. Suddenly you play piano, something like that. But oh man, would I be skeptical.

你想怎么死？快速无痛苦。怎么个快法？不知道。比如在睡梦中中风或心脏病发作，那时我已经很老了，过得很精彩之类的。如果能延长寿命，你想活到多大？

How do you want to die? Quickly and painlessly. How so? I don't know. Like a stroke or heart attack in my sleep when I'm really old and I've had a great something like that. And if you could extend your life longer, how old would you like to be?

我最近刚满 40 岁。我当时想：‘好吧，传统上这大概是人生的一半。’我觉得还行。如果一切顺利，我估计自己能活到远超 80 岁，但我觉得自己已经活得很充实了。我不会改变什么。不。但我真的很想保持健康。我非常看重这一点。

I turned 40 recently. I was like, 'All right, this is kind of traditionally about the halfway point.' And I felt okay about that. I assume I'll live much longer than 80 if things go well, but I was just like I had a very rich life. I wouldn't make a change. No. But I do really want to stay healthy. I really value that.