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This is an iHeart podcast. Guaranteed Human.
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I'm Malcolm Gladwell and you're listening to Smart Talks with IBM. When Dr. Lara Jahei began treating epilepsy patients in the early 2000s, she noticed something unsettling. Different surgeons could look at the exact same case and recommend completely different treatments. One surgeon might remove one part of the brain, another a different part, and a third might not operate at all. Dr. Jahai believed there had to be a better way, one grounded in data. That conviction set her on a path that would lead her to become chief research information Officer at Cleveland Clinic and the executive program lead for the Discovery Accelerator. The Discovery accelerator is a 10 year partnership between Cleveland Clinic and IBM where researchers are using AI and and quantum computing to make incredible discoveries in healthcare and life sciences. I sat down with Dr. Jahi to explore what's happening now, what's possible with quantum computing, and where this next era of biomedical discovery is headed. Epilepsy was your kind of specialty within neurology, correct?
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Yes.
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What led you to that?
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I was always fascinated by the brain. You know, it's the part of our body that lives still to this day, the most to be discovered. So I was always intrigued by areas that leave more for discovery. And epilepsy was my pragmatic side, wanting to choose a subspecialty where the problem can be fixed. In epilepsy, there are many medications that are very effective and there's a brain surgery that we can do to stop seizures when medicines don't work. That attracted me, you know, compared to other areas in neurology, like stroke, for example, or dementia, where usually the damage is more definite. I wanted to be able to tell my patients that you have a big problem, but here's what I can do to fix it. And epilepsy offered me that.
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B
But what were. There must have been interesting and intriguing unsolved problems in neurology.
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Oh my gosh, it's the whole brain, isn't it? Before starting to deal with artificial intelligence in research, right. In the neurology, I'm dealing with real intelligence, the human brain and how it works and how we think and how we make decisions and how it can grow and evolve. And so there is many untapped questions in neurology, and that's part of the fascination in it. In epilepsy in particular, it's an electrical disease in the brain. It's actually one of the conditions in neurology that's a perfect alignment of all of the scientific disciplines. It's biology and physics and chemistry, all working Together to make us who we truly are. Right. So every other discipline, if you think of computing, for example, it's purely electricity, or if we do drug development or drug discovery, that's mostly chemistry experiments in the lab, that's mostly biology. But the human brain is all of those put together. The cells in our brain secrete these chemical substances that diffuse everywhere and hook up where they need to to trigger certain circuits and then trigger some effects afterwards. So it was just an elegant science that has big impact.
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B
We're shortly going to get there and talk about you've taken on this kind of very technology focused research role at Cleveland Clinic. I'm curious about if I go, if we go back to when you were just starting out at Cleveland Clinic.
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Yeah.
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How much were you thinking about this sort of technology piece, about what technology could do for your specialty, about was that on your mind or is this something you've sort of come to more recently?
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Well, it's been a journey. Right. And when I started training as a clinician, my priority was just to learn how to better care for my patients and how to be a better physician. Right. And then I realized that clinical practice provides an immediate reward. Right. I'm interacting with a human being and helping them in the moment. So there is that immediate reward that comes with that. But that wasn't enough. I wanted something more. So then I learned biomedical research practices and research offered me this path towards a future. You know, the reward there is more long term. I'm studying, discovering things that could help many people in the future, even though I will never get to see them or meet them or, you know, have that immediate satisfaction. So that shifted me from being a pure clinician to being a clinician scientist. And as that journey progressed, it became very clear as medicine evolved over the past 20 years, that we cannot do any good biomedical research without understanding data and technology. You know, the balance is shifting from most of the research is happening, we call it, you know, on the wet bench with actual experiments, physical experiments, to a place where most of the work is happening through compute and simulations and data. So I became much more involved for my personal research in building big data models and learning about AI and learning about technology in general. And then as that journey progressed, I was fortunate enough to be in a role for Cleveland Clinic, where my job is to bring that technology and bridge it to research for all researchers across our healthcare system.
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When you were talking about how in your own research you were moving in that direction, what was your own research focused on? What were you looking at?
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I was looking at brain surgery for epilepsy. It's an intervention that's been around for decades, actually. But when I started practice, I was shocked by the practice that we had where making decisions around surgery, like what patients should get it versus not how likely is it to work, what part of the brain should we remove? All of those decisions were at the time, in the early 2000s, driven by clinical opinions. You have an experienced surgeon, they decide to do this, somebody else might decide to, to do something completely different. And I didn't feel that that was the right way to practice medicine, you know, that we needed to be more evidence based and data driven. So I went in the business and research of building models, predictive models that can ingest data from all of the tests that we would do about on these patients before to figure out surgery. So, so I learned how to analyze all types of data, from genetic data and individuals to pictures to electrical recordings, and then combine those into these prediction models.
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So basically you're looking at, you're taking large numbers of surgeries for epilepsy and you're seeing what kind of connection there is between the success of the surgical intervention and the underlying presentation of the patient.
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Exactly. So I would be telling the patient, what is your specific chance of becoming seizure free with surgery? Instead of giving them statistics about, you know, like, you know, in general, how well is that going to be effective? So that piece of individualizing medicine.
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So Cleveland Clinic decides to create a post called Chief Information Officer.
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Chief Research Information. We have chief research Information Officer. Yes, always Chief Information Officer. Chief Information officer runs it.
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Oh yes. Chief Research Information.
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Yeah. So it for research.
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This is parenthetically a huge job.
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Yes.
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So you apply for this, do you know that you're going to be thinking and talking and dealing with quantum.
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I started in January 2020. And like every leader who's put in a position, remember, you know, everybody tells you you should read that the first 90 days about how to plan. So I was reading that and doing my listening tours to understand and then Covid hit and I got a call from our executive suite about, oh, Lara, there is this thing called Covid that's coming. We will start testing people in four days. People will want to do research with COVID make it happen. So there's no chapter in the book about that. So then it was like a pressure cooker test with, yeah, I have to create this access to data, structured resources so that we can learn from it as quickly as possible. So that was a catalyst. So then comes 2021. That was the year of our centennial. 100 years for Cleveland Clinic. So everybody, not just me, we were in a mindset where we were thinking long, long term. You know, like, what made us special up till now? How do we stay relevant? Where is the world going to be 10 years from now? And what should I get going right this moment to shape that and be ready for it? And that's when Quantum came in my mind, where unless we invest in it now, 20, 21, we will not be ready for this next compute revolution that's coming after AI.
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Everybody in the world right now is doing nothing but talking about AI. And you are already thinking one step beyond a quantum. What's different about the opportunity that Quantum creates for medical research than AI biology?
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The human body, by definition, is much closer to fundamentals of quantum, to quantum mechanics and quantum physics than it is to AI. AI is a classical computing approach that in essence reduces every piece of data to a black or white binary categorization of a 1 or a 0 at its core, nature around us, the human body, there is nothing categorical about it. It's that whole continuum of colors of life Quantum. Its principles are that. So there's all the scientific principles about quantum physics and superposition and entanglement, all of these complex things that people have a hard time with. But in essence, it really is much more aligned. Like, if I want to draw a colored picture, I will not go and pick up charcoal. It's much easier for me to draw it if I had a colored palette with me. And Quantum offers that there is plenty of situations in medicine that are just intractable. Meaning it's not an issue just of AI being slow or it doesn't have enough data, or if only we got more GPUs, we can answer those questions. There are some problems in medicine that are fundamentally such that even if you give me all the GPUs in the world, there is no way that AI can model accurately how these molecules in the body are interacting among each other, or how compounds, electrons, are moving within the mitochondria. These are the engines within our cells. There's these fundamental things in biology that AI and classical computers are just not built to be able to simulate.
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B
So you must go to dinner parties. Dr. J. Hye. People must ask you, what is quantum computing? What do you tell them?
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Yes, although I often, you know, we talk about other things at dinner parties.
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No, eventually it comes down to if I was at that dinner party with you, I would ask you, what is quantum computing?
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I would say, depends on how much Time we have at the party to explain it. The short answer would be, it's a completely different way of working with computers than what we're used to right now. You can imagine that AI as being like a car that you take to go from one place to another. No matter how fast that Ferrari can get and how much fuel you put in it, it's never going to be a fighter jet. It's never going to be a plane. AI is the car. The plane is quantum. They are ways to get from point A to point B. But they work very differently, and we always use them together. If I'm flying from Shaker Heights to Yorktown Heights, I drive to the airport, get on the plane, then take an Uber to get to Yorktown Heights. In research, we would do the same. We do some piece of it in AI, some piece of it in quantum, and then go back and forth.
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Back in 2021, Cleveland Clinic and IBM announced that they were starting something called the Discovery Accelerator. What is that?
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It's an initiative, a program, a partnership really, that is designed to bridge advanced computational tools and technology through the leader in that space, IBM, with biomedical science and research and life sciences problems, and that is Cleveland Clinic. We called it the Discovery Accelerator because that was our goal. You know, we were both on both sides, challenged with the fact that discovery in medicine was just taking too long. The classical example that really brought it to life to us then was drug discovery. That it took over a decade, and it still does, actually, over a decade from the moment that there is a compound that someone in a lab, biomedical lab, thinks it would be effective to treat a certain disease. It takes about 10 to 13 years from that moment to when that drug is on a shelf for a patient to get to from a pharmacy. And that was just too much of a gap to allow when we have so many health conditions that we needed to address. And a big part of that gap could be computationally solved. Better simulation of compounds, designing drug trials that are more efficient, you know, that would finish faster. So that was the motivation to bring computational tools and technology closer to biomedical researchers.
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Cleveland Clinic and IBM team up, and I'm assuming the IBM quantum guys and other people descend on Cleveland, and you have your first meeting with them. Are they telling you things you had never thought of, or. I mean, I'm just curious about what's the difference between what you thought was the potential was and what you discovered the potential was?
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That is an excellent question. If I had to prioritize one lesson that I learned over the past few Years of doing this. It is that you can never know what your, you know, where your brain is going to go and discovery until you talk. You know, you have to open it up and really listen to try to learn what the other people are saying. It went both ways.
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B
Can you give me an example?
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So, okay, we built the quantum, right? So it took like eight months to get this machine put together, and we put it in our cafeteria. That's a whole other story.
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B
Wait, you put the quantum machine computer in your cafeteria?
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Yes, yes, yes.
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Wait, can you see it when you're eating lunch?
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Yeah, yeah. We have people eating lunch around it all the time. We wanted to have a machine that people can see. Otherwise the program wouldn't launch properly. So I needed to have it physically. So we had to look at, retrofitted an existing space and the cafeteria space worked out. It was far enough from the street. There was no vibration. It was a double floor, so the ceiling was high enough. It just technically fit all of those requirements. And it was either there or we put it in our data center, which is a building in another city close to Cleveland, and we picked the cafeteria.
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B
Now, what. I know this is sort of. This is kind of hilarious, but there's a serious point here I want to touch on, which is why do you need it on premises? On the premises.
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Cleveland Clinic research. We needed to change how we think about research and shift the mindset of all of our researchers and all of our researchers. I'm talking about 3,000 individuals who are 100% doing biomedical research in Cleveland Clinic. 230 labs, individual PIs. So that's the scale that I'm talking about that we had to create an impact on. So having it be there was as much for inspiration and to trigger, motivation to change as it was a practical solution, say, because we had the space and the connections and all of that.
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B
I saw one at IBM headquarters. They're beautiful. They're works of art.
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They are. They're gorgeous. And the one that we have is the most gorgeous one of all. This is not me. The mom bias talking about is they got an award, the red dot award for. Went to IBM and Cleveland Clinic for our quantum and the quantum that IBM built for RPI a couple of years after hours. They modeled it after hours, not after the ones from before.
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Just so people know, we're talking about basically a small garage.
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11.
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About that size.
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11 foot by 11ft. 11ft. You know, the cube.
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Oh, smaller. Yeah, yeah.
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So it's a glass cube, and the glass comes all the way From Italy. It's the same glass that protects the crown jewels and, you know, the Mona Lisa and all that. So there is the glass all around, and then there is the tube that you see, the stainless steel that's shiny and, you know, and clean. But the technology is all inside of it. You know, the chandelier and then the processor in the bottom. And it's just a fascinating thing to watch. And it hums. It makes a sound so even it sounds alive.
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You have a great deal of affection for your quantum computer.
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Yeah, we love our machine.
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I want to go back to something you said before, which is when you had your initial conversations with IBM, both sides learned things that they hadn't previously thought of. Give me an example of something that either side hadn't realized could be done with this new technology.
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Sure. I mean, at the Cleveland Clinic side, we thought that what Quantum should be good for is that it would be a faster computer. Right. So that we have these big data sets that are requiring much more compute power and GPUs than what we have, and we should just run them on the Quantum. And what we came to realize is that Quantum actually does not do well with these large data sets. What it does well with are smaller, better defined data sets, but ones where simulation is more important, where we have to run them through multiple models, multiple simulations of how they interact. As an example, one of the very first projects we throw at Quantum was wanting to predict complications, cardiac complications from general surgery, using electronic health record data. So data from our electronic health records are by definition these really big data sets. You have in them every single thing that you know about the patient that you've collected. And we thought that Quantum would help us build models, better models with this data, and it failed miserably. It wasn't good at doing that thing.
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And why didn't it like that problem? Because it's too big and unwieldy?
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Well, because the hardware isn't ready. Right. So the hardware with Quantum, the issue was back then, you know, now we've upgraded our processor. But still. Still Quantum now is limited by noise and by its ability to correct for errors when it's doing computation. And the more data that you throw at it, that you require it to put in its system to model interactions, the more errors it's likely to make. So then the harder it is for it to get to an answer that you can trust. Now, we made a lot of progress since, which I'm sure we'll get to. I hope we'll get to. With some recent Breakthroughs that we made in that space with modeling large compounds and interactions. But the way that got us to where we are now, where we could model large interactions, it took us figuring out that we shouldn't be doing everything on quantum.
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B
So give me an example of a problem that quantum is ideally suited for
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that Quantum really likes in drug discovery. For example, in chemistry. It likes chemistry a lot. Because in chemistry, what it has to. What we wanted to model is how a drug that we put in our body is going to interact with. We say the, the protein, you know, the target, the ligand that it needs to bind to. Like, you know, the drug is a key, and it needs to fit in a lock in certain parts of the body to open it, get in, do its thing. And there are many keys, many potential compounds that we could test for many parts of our body. We don't really know how they're going to interact. Traditionally, what we do is we have to build all the keys, we have to manufacture all these compounds and then do actual clinical trials, put them in people, put them in animals, and see what happens.
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B
See which one is best.
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Yeah. Which two fit best together. So we used AI to try to help us with that. But AI can only model what it had learned. Right. So for rare diseases, conditions that there isn't enough information out there on what the, the locks look like, it's really hard to then model it with AI and get an accurate prediction of whether there's a fit or not. Quantum does not rely on the previous data for its modeling. Quantum does its modeling purely based on the physical characteristics of the compound of the key that you're designing. So that makes it ideal because it's then untethered with. It's not limited by do we have enough samples or don't we have enough samples or what did previous studies find or not? It's purely based on those physical properties, those quantum properties. So we found ourselves in situations where we were able to predict the fit between certain targets and where, in conditions like Alzheimer's disease, for example, we published where the quantum based modeling of the compound was much better than what we would have gotten with what we got. Right. Like, we did it both ways, and the quantum one was a better fit than the AI generated one.
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B
Is this fair? Quantum is a little more of an artist and a little less of a. Of a kind of nerd. AI sounds nerdy to me. Quantum seems like creative and artistic.
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Creative, yes.
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Creative, yeah. Yeah.
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It's like people. Yeah. It opens up paths that you never knew existed. That's why, when I get asked about what do I see is the best, you know, the most important breakthrough that Quantum is going to allow us to do? My answer is I really don't know. Because whenever people invented these new technologies, I don't think they really knew that they're think of laser. I don't think the person who invented laser thought that they would be used to scan groceries at the grocery store. Developing technology, the way I think of it is like having a baby. You raise it as best you can, but then they're going to go off and do their thing and you will be tying them down if you restrict them to just what you thought they should do. So it opens up that space, that creative space for us to ask questions differently than we used to. We should train our mind to stop starting from classical and then trying to squeeze it into quantum. We have to learn how to think quantum upfront right from the beginning, which we haven't really been doing as a scientific community since our inception. We were trained in how do you convert what you're thinking into a formula that you can ask from a computer, which is a classical computer with Quantum, because of how it works, it can answer questions, it can look at problems in a very different way. So we have to think differently about the questions and how we ask them.
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B
With IBM, you recently modeled a protein with over 12,000 atoms. Talk to me about that and why it's so meaningful for drug discovery.
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So in October of 2024, so just 18 months ago, the largest compound, biological compound that could be simulated with quantum was 10 atoms big. And it was unfathomable back then that we will get past the thousand or few thousand atom simulation in the foreseeable future. And what Our team with IBM and with Riken in Japan published last month, April 2026, is a simulation of the electrical properties of an enzyme Trypsin in the body that is 12,600 atoms Big orders of magnitude beyond what anybody thought was was possible in that span of time. And the reason why that happened was because of innovations in the technology itself, where the teams stopped thinking of Quantum and AI as competitors and instead thought of them as different members of the same team. Right. We're now in basketball season in the US the npa. And you need defense, but you also need your center. You need somebody to shoot. You need all of the pieces to work together. So with this, it was figuring out, where do I put, when do I put AI on the field, when do I put Quantum on the field and how do I tell them to work together. It's the scientific term is the quantum centric supercomputing. So quantum is at the center, but we're using our supercomputing tools, AI classical, to interact with it and split that big problem of the 12,600 atoms into pieces, where some pieces are best served with quantum and others are best served with classical.
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B
This distinction that we now cling to, AI and quantum, are these very different things developed by different people for different purposes. What you're suggesting is that's probably going to go away in the future. These things will work together. It's going to become teamwork and not one on one competition.
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A
Exactly. And it is that now in Cleveland Clinic, I mean, the way we've evolved our priorities with IBM, it's a realization that both organizations have come to where really for progress to happen, we should stop seeing them as separate. We should put them together and work to the best of what each piece of technology can provide.
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B
One theme running through a lot of what you've been talking about is that the arrival of this new technology requires the researcher to behave differently. And that's one of the reasons why you want the quantum machine on full display. And then you were talking about how you have to ask different kinds of questions. I'm curious, can you elaborate on that a little bit? So take me back, for example, to your earliest days. If I had given you all these tools that people have now, how would your research have proceeded differently? What would you have done differently?
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A
You know, I would have looked at the molecular components of the human brain as they relate to outcomes of brain surgery way earlier than I did. The first 10 years of my career doing research was all spent building models that were purely based on brain waves and pictures of the brain. It wasn't until after I hit a wall with my models aren't getting past that 80% accuracy threshold that I started thinking, oh, you know, there must be something genetic or, you know, more biological that is influencing this. Had I been exposed to quantum, at least as a concept, right. To quantum computing and what quantum science is back then, I think it would have opened up my mind to realize that it's not just about what I see. You know, there is hidden relationships that exist within the human body, and that's our genetic makeup and our chemical makeup that influence what comes to the surface, that urge to dig deeper. The other thing it would have changed is it would have made me reach out to engineers and physicists and mathematicians much earlier in my career.
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B
Yeah, yeah, yeah. And how would it have changed this is a very kind of prosaic question, but the just kind of the day to day life of someone doing medical research, I mean the, oh wow, you walk into the office in the morning. How does your day proceed differently when you're, when you have these kinds of tools at your fingertips?
- [35:18]
A
That's the fundamental question in biomedical research right now. And it's less to do with quantum, more to do with agentic AI, right? These agents that we can work with now to help us how to think more creatively and how to do work that up until now was more like Scott work that, that the researchers had to do, whether it was, you know, so the hypothesis generation has always been the most creative part of aspect of scientific research. But what comes after it? With data collection, for example, that was always such a repetitive, you know, exercise. And then the analysis after that was something that was very resource intensive and you had to try so many different approaches before you get to an answer. And that was fairly complex. Now with access to agentic AI and some quantum, of course we can spend more of our energy on the creative thinking part of the aspect of the work and less on the, you know, just the repetitive.
- [36:45]
B
When you look around, I'm assuming you walk around Cleveland Clinic and you have lots of conversations with some of the most brilliant medical researchers in the world. Are you satisfied with how quickly and aggressively they are adopting these new technologies or do, do they still need encouragement from you to. Do you have to say to people, wait, I've got this machine in the cafeteria, you should be using it for this problem. How much are you doing that kind of encouraging and cheerleading or is it unnecessary?
- [37:17]
A
No, there's plenty of cheerleading. That's necessary people. You know, humans don't like to change. Yeah, it's hardwired in us. So there is plenty of cheerleading. But what happens is, I mean the way we built our program to where we are now. So Cleveland Clinic now is pretty much winning every global competition in Quantum for Life Sciences, whether that's the Wellcome Trust, Quantum for Biological Applications. Our partner there was a startup in Finland, Algorithmic. They're brilliant. We worked with them to develop a photodynamic drug therapy for cancer or whether it is the NIH where they had an X prize challenge for Quantum or universities that we're collaborating with. We have a program that's bringing startups to our ecosystem. We give them access to the machine. If they have a question that is significant enough for life sciences universities that we're building, Bachelor's, Master's, Ph.D. programs with, on quantum computing, we develop that whole ecosystem around it. If that's not cheerleading, I don't know what else would qualify for cheerleading. But then what happens is these early adopters, the risk takers, become the cheerleaders themselves, right? And then they work with it, they achieve success and we're nothing but competitive in medicine and science, right? So then it becomes, okay, so and so did this with this machine, let me learn it so I can do the same. And it becomes this virtuous cycle of then innovation and growth and people wanting to work together. It's just been fascinating to watch.
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B
You said that people don't like change, but you clearly do.
- [39:21]
A
I do. That's the mindset of researchers. A researcher is someone who is not afraid to fail, actually sees failure as a chance to learn something, to do better the next time. So we get rejected all the time and we don't care. We keep moving on with papers, grant applications. So that mindset is what all of research is built around. So it's a very forward looking mindset. And Cleveland Clinic as a health system, we wouldn't have survived 100 years. We wouldn't have done all of the firsts that we had. Serotonin, the chemical that drives the whole science of psychiatry and neuroscience that was discovered in Cleveland Clinic. So as an organization, we have enough of people who think that way that they will be the early adopters who will pull the others with them.
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B
Yeah, yeah. One, one last question. Look, look ahead 10 years. Paint me a picture of what Quantum and related technologies look like for a place like Cleveland Clinic in 10 years.
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A
Well, what I hope is that 10 years from now, if I'm seeing a patient in clinic who has bad epilepsy, and for the love of, you know, I can't figure out what medicine do I need to prescribe to them to make them seizure free. I will be able to send them to get a blood test that we can then run through some analytical platform that leverages both quantum and AI that can model exactly for that patient what compound, either existing or not to be developed. Some new chemical that we haven't tested for that indication yet is going to treat them, you know, make them seizure free. It's. And I think quantum is ideal for a condition like mine, epilepsy, because we are a rare disease and I think that benefit that it's going to have will start with rare diseases, you know, as I explained earlier. So take any other rare disease, we should start there and then expand from that to more complex things like cancer for example and others. But those rare conditions where we are left now completely scratching our heads and going by intuition, it will make our care truly precise and it will make drug development a more tailored exercise than the way it is now, where it's like a hammer that's looking for nails.
- [42:28]
B
Am I right in thinking that of all of the over the hundred year history or more now of Cleveland Clinic, this sounds like the absolute best time to be at Cleveland Clinic.
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A
Yeah, I love it.
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B
Do you have no complaints?
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A
No complaints. And I am hiring. I need those quantum researchers, those people who are wanting to apply quantum genetic research, imaging research, every single aspect of biomedical research. We can't afford to just wait on the sideline until the technology is ready and then it will teach us it is ready now. That 12,000 Atom simulation wouldn't have happened just a year and a half ago. It couldn't. Done.
- [43:18]
B
So the headline of this conversation is we're hiring.
- [43:21]
A
Yes. Yeah, that's a good headline. We're growing. How about that?
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B
Smart Talks with IBM is produced by Matt Romano, Amy Gaines McQuaid, Trina Menino and Jake Harper. Engineering by Nina Byrd Lawrence mastering by Sarah Bruguer, Music by Gramoscope, strategy by Cassidy Meyer, Sophia Durlon and Tatiana Lieberman. Special thanks to Dr. Lara Jahai, Alicia Rio Cooney and the Cleveland Clinic team. Smart Talks with IBM is a production of Pushkin Industries and ruby studio at iHeartMedia. To find more Pushkin podcasts, listen on the iHeartRadio app, Apple Podcasts or wherever you listen to podcasts. I'm Malcolm Gladwell. This is a paid advertisement from IBM. The conversations on this podcast don't necessarily represent IBM's positions, strategies or opinions.