San Juan Islands Excursion

On Saturday I was up bright and early to catch the Victoria Clipper catamaran up to the San Juan Islands, where colleague Lynn and I had planned to go on a whale watching trip. The clipper is an ideal way to explore Puget Sound, also known as the Salish Sea after the indigenous people of the region, and get an appreciation for the size, location and character of its many islands.  The place names evoke the times of exploration and smugglers and could come straight out of 'Swallows and Amazons'.

Heading north, we sailed up the east side of Whidbey Island, past Possession Point at its southernmost tip and on up through Saratoga Passage, which lies between Whidbey and Camano Islands.  Whidbey Island is the largest island in Washington State, around 60 miles in length.  We rounded the top of Whidbey and sailed through the narrow gap of Deception Pass, from early morning clouds into bright sunshine on the far side where the San Juan Islands were scattered like jewels across the blue water, rising thickly wooded from sandy shores.  We sailed around Lopez Island and past the foot of Orcas Island, which has the highest peak of all the islands, Mount Constitution, to reach Friday Harbor in San Juan Island.

By now the sun was blazing and Lynn and I enjoyed strolling around the local art galleries, admiring sculptures and paintings by local artists.  We stumbled on a farmers' market where locals were selling everything from home made goat cheese, smoked tuna, clams and oysters and lettuces from the islands, while wandering minstrels strummed on banjos or sang, barbershop style. It was just delightful.  We grabbed some seafood (delicious Dungeness crab roll for me, fish tacos for Lynn) from a gourmet food truck in the harbor before boarding the boat again for the whale watching part of the tour.  This had been pushed later in the day when the crew had received reports from other whale watching boats in the morning that there had been no whale sightings in the area.  Happily patience was rewarded and we sped up to Canadian waters to find three humpback whales feeding off Saturna Island. 

We followed the female (identified by the white spots on the underside of her tail flukes) for quite some time before heading back to Friday Harbor.  I was a little disappointed not to see orcas, of which there are three resident pods of as many as twenty animals each that live in Puget Sound and feed on salmon, but apparently they had been spotted the previous day far, far north in British Columbian waters and evidently they were still up there, out of range of our boat.  We did see a couple of harbor seals basking on a beach, a couple of bald eagles and some pigeon guillemots and cormorants, and we sailed past islands where blue herons and tufted puffins nest, but we weren't close enough to actually see the birds.

The long (three hour) cruise back took us around the other side of Lopez Island and then across the Strait of Juan de Fuca, which opens on to the north Pacific, and down the other eastern side of Whidbey Island which is much less sheltered, with eroding sandstone cliffs facing the water. It was a beautifully clear afternoon and we could see the Olympic mountain ranges to the west, and the Cascades to the East, starting with Mount Baker in the San Juans all the way down to Mount Rainier, south of Seattle.  The Seattle skyline was just spectacular, with Mount Rainier one side and the Space Needle on the other, reflected in the blue water.

Two months in

Friday marked the completion of my second month at the Foundation.  Having only one more month full time in Seattle, I am now trying to make sure I meet and get acquainted with everyone I may need to interact with as well as complete my training - a three day course entitled 'Starting Gates' next week - before I start working remotely from home.  I have to start planning how to get all the 'stuff' I have accumulated up here home or find places to store it, as well as make plans to access cellos to play in the weeks when I am in Seattle.

We have been enjoying a spell of gloriously warm and sunny weather, and I am taking advantage of the long evenings (the sun doesn't set until nine) to continue my explorations of the city on foot.  On Thursday I hopped on a bus over to St Mark's Cathedral and from there walked all the way down the Blaine stairs, the longest in Seattle, to the east side of Lake Union, and then up the parallel Howe stairs to the top, with a scenic detour to tranquil Portage Bay, where Canada geese and goslings swam between the boats moored in the marina.  On Friday I had a lovely solo dinner at a local restaurant called 'Crow', sitting at the counter watching the chefs toiling over the range while I sipped my wine and ate a pink grapefruit and avocado salad followed by basil icecream with strawberry syrup, and then spent a quiet evening grocery shopping and doing laundry,

A productive day

Today, enjoying a temporary lull in work on specific grants or investments, I turned my attention to working on process improvement projects.  I volunteered to work with the Foundation's Diagnostics team to adapt the processes and documentation that we use to guide development of drugs and vaccines to be appropriate for Diagnostics development.  We are making very good progress in mapping one to the other and I am learning a lot along the way, which was my motivation in volunteering.

In the afternoon the pneumonia portfolio was reviewed by the Foundation President of  Global Health.  I was delighted when he reinforced my role as a co-leader together with the Program Officers of team meetings.  The Portfolio and Platform Lead role is relatively new and it is very helpful to have the President himself reinforcing the breadth of my involvement and specifying the areas for which I'm responsible.

By the end of the day, there wasn't a cloud in the sky and I couldn't resist taking a long walk to enjoy the clear evening.  I started at Lake Union and climbed the Galer steps all the way to the top of Queen Anne Hill. What a great work-out! The views were gorgeous - I saw a float plane landing on Lake Union and from higher up, Mount Rainier was visible, peeking between the skyscrapers of downtown like a primeval monolithic Godzilla.

A second business trip

I am sure the novelty of my trips with the Gates Foundation will wear off soon, but meanwhile here's an account of last week's travels, which took me to a vaccine manufacturer just outside Washington DC. A large portion of our 'investment team', eight members in all traveled together to seek answers to questions that had arisen in our review of the vaccine manufacturer's grant application.  There is no better way to get to know your colleagues than to travel together and I managed to establish a reputation as an excellent navigator after riding in both of the two cars we hired with my trusty printed directions from Google Maps.

The meeting itself was very productive - it was exhilarating sitting in a room filled with such expertise in vaccine development on both sides of the table and to be able to contribute to the discussion.  We ended the day with all the answers we had been seeking and a group photo to boot.

Things have been a little quiet in the office due to the long Memorial Day weekend. I flew back home to San Diego for the first time in two months and ironically while the weather down south was grey and drizzly, it was fine and sunny back in Seattle.

A cultural weekend

Having completely caught up with all my work on the flight back from New York, I enjoyed a weekend of culture. Saturday morning I went to the Seattle Art Museum, which has a wonderful collection of Northwest Native American art with totem poles, raven masks, robes and other artifacts. There were several French Impressionist paintings I've never seen before in books, as well as a set of four beautiful Flemish tapestries depicting Chinoiserie scenes, woven in 1700, and a piece that Jonathan would like with whole cars suspended from the ceiling with light tubes radiating out of them like starbursts.

I swung by Pike Place Market on my way back to buy some salmon - the Copperhead is just in season - and bread from the French bakery and cheese from Beecher's and a bunch of sweet peas whose peppery fragrance now greets me every time I walk into the apartment.  In the evening I hopped on the monorail to go and see the movie 'Woman in Gold' in which Helen Mirren plays Maria Altman, the woman who sought restitution of Klimt's portrait of her aunt, Adele Bloch-Bauer from the Austrian government, 50 years after it was unlawfully seized by the Nazis.  The film is well worth watching.

On Sunday morning I took the bus up to Volunteer Park, where the Asian Art Museum is located.  I was disappointed that the famous Japanese gold screen painted with crows was not on view but enjoyed watching an amazing animated mural by Chino Aoshima. Imagine a whole wall filled with detailed computer animation of a city and countryside under a volcanic eruption..  The Seattle Ikebana Society was also exhibiting today and I enjoyed the clean lines of their flower arrangements.

I rounded out the day by playing cello and piano sonatas with Chris from work.

First business trip

Today's blog post comes to you not from Seattle but from New York, where I attended the inaugural Scientific Advisory Board meeting for an influenza vaccine program led by researchers at Mount Sinai Medical Center.  Graduate students, distinguished flu experts from WHO and NIH and senior leaders responsible for vaccine development from several big pharma companies crowded into a seminar room on the 16th floor to review plans for the development of this vaccine.  Needless to say I learned a lot about flu while enjoying a spectacular view over the north end of Central Park and the George Washington Bridge.

I continue slightly star-struck from Tuesday's employee meeting. Yesterday evening I had my appointment at the photographer's studio, complete with hair and make-up. Yes, every foundation employee has to have a professional head shot. I rushed from my last meeting of the day, jumped into an Uber taxi and spent a very enjoyable hour being pampered, beautified and flattered from every angle. We shall see if the camera lies...Then it was time to jump in another Uber taxi and be whisked to the airport to catch the red-eye to New York.  It turns our that foundation travel policy is to fly business class if you are on an overnight or international flight.  I haven't flown business class since my heady consulting years in the late '90's. I slept very well in consequence.

Annual Employee Meeting

How many companies can boast Bill and Melinda Gates, Bill Gates Senior, Warren Buffett and Bono as speakers at their annual employee meeting? I came away inspired and star-struck.  All the 1,391 foundation employees trooped across the street to a large theater in the Seattle Center for a series of panel discussions and keynote speeches to celebrate the first 15 years of the Bill & Melinda Gates Foundation.

Some of the most inspiring moments were hearing the story of GAVI, the Global Alliance for Vaccines and Immunization, which was launched in 2000 with strong support from the foundation and has since changed expectations for how fast new vaccines can be introduced in every country around the world; hearing Melinda's personal story of how she became an advocate for family planning; and a few simple but powerful words and reflections from Bill Gates Senior.  Some levity was provided with a muppet show from one of the side boxes featuring the foundation's version of Waldorf and Stadtler (aka Bill Sr. and Warren).

Warren Buffett and Bono were each captivating.  Here are some of their pearls of wisdom.

Quotes from Warren Buffett:
On being asked what were the biggest surprises of the last 15 years - ' Speaking personally, I'm surprised I'm above ground.'
'The only conceivable pleasure I could get from all those stock certificates sitting in the safety deposit box is if I went down once a year and fondled them. The money's had more impact this way.'
On his decision to give his fortune to the Bill & Melinda Gates Foundation - 'Bill and Melinda are young, bright and hardworking. They are one of my best bargain purchases.'
'We've been extraordinarily blessed. These claim checks we pile up have very little marginal utility to me and much more utility to other people.'
From his business partner at Berkshire Hathaway, Charlie - 'You'll end up agreeing with me because you're smart and I'm right.'
On the 50th anniversary of Berkshire Hathaway - 'It's not over yet - Charlie's 91 but he can still hear and I can still see.'
On his Coca Cola consumption - 'I'm sort of like an antique car. If you change one thing it falls apart.  I read that six year olds have the lowest mortality rate of any male age group, so I eat the diet of a six year old.'
'Praise by name and criticize by category.'
On stewardship - 'Decide not whether it [the way you spend] is good or bad but whether it's best'
On his meeting the next day with Mary Barra, CEO of General Motors to comment on the need for good stewardship - 'Of 2,000 US auto manufacturers ever started only one is solvent today. That's what capital markets do for you. Foundations have to do it for themselves.'

Quotes from Bono:
On his first meeting with Bill and Melinda at their home when he surprised them by asking about their faith - 'Coming to grips with the force of love and logic in this universe is much easier than silence for this Irishman.'
'The arc of the universe bends towards justice' (Martin Luther King). You are not just involved in charity, you are involved in justice.'
On learning of Warren Buffett's gift to the foundation - 'We look for cosmic rhymes and poetry and if we do look, we find it. I knew this was a seismic change - the symbol of it as well as the weight and import of it.'
'Even these people don't have pockets deep enough to fix the whole world, they are using the foundation as leverage with the moral authority to cajole governments to increase aid. Our job is not inside maneouvering, it's outside mobilization. We have to do this all over the world with Global Citizen as the badge, the wind in the sails of a social movement to persuade heads of state to act.'

An evening filled with chamber music

I was very excited to be introduced to a fellow string player who works at the Foundation.  It turns out she put out a call for musicians to play chamber music in January and found two violinists but was still seeking a cellist.  We met on Monday evening in a conference room at the farthest corner of the Foundation and played a Mozart string quartet. Bliss!

Later the same evening I enjoyed playing more chamber music - this time Brahms piano quartets with Becky, Pam and Chris.  What a treat!

Seattle Beer Week

Jonathan's arrival in Seattle coincided with the start of Seattle Beer Week and a strange temperature inversion that brought sunny skies and seventy degree temperatures to Seattle while sending rain and snow (in May!) to San Diego.  We lost no time in sampling the best brews the city had to offer (even though I was still hobbling around in my protective boot).

We started on Wednesday evening at the Pike Brewing Company where we tried the seasonal samplers - the Houblon Saison was declared a winner.  On Thursday we ventured up to Fremont, starting with a Cascade sour beer tasting at the Sixgill, and then moving on to Fremont Brewing, where I enjoyed the orange and earl grey IPA, and ending up at Outlander, where we sampled an amazing array of ten innovative beers produced by this tiny nanobrewery in a Victorian house. Friday's treat was a beer and food pairing (cheese, artisanal sausages, pork shank sliders and goat cheese fritters) at the Bell and Whete led by Dave Adams of San Diego's Green Flash beers.  Even though we are beer snobs we learned some interesting new facts about brewing. We walked up Capitol Hill to The Pine Box, a mortuary converted to a bar, for a nightcap.

On Saturday I threw caution to the winds and removed my boot. So far my foot seems to have recovered.  We spent the day exploring Ballard's breweries including Hales, which uses the traditional English open tank method (thumbs up), Bad Jimmy's (thumbs down), Reuben's Brews which had just opened a new facility and deck (excellent), then Hilliard's Beer which occupies an old roller skating rink (interesting tequila barrel aged saison), and lastly Populuxe. We saw several cycle saloons visiting the same breweries - these are bicycles made for 10 with a bar down the middle, but ironically these pedal powered bars are not allowed to serve alcohol! Saturday evening, we felt strangely tired (I wonder why...).

On Sunday we spent a very enjoyable morning at the Museum of Flight, highlights of which included artifacts from moon landings, the original red barn in which the Boeing aircraft factory had its beginnings, and the galleries on World Wars 1 and 2 which told the story of the war through tales of legendary pilots, men and women from many different countries. The bus ride back took us through neighborhoods of Georgetown and Sodo, which merit further exploration some time soon. We finished the weekend with another beer pairing dinner back at Outlander.

Global Partners Forum - Part Two

The second and third days of the Global Partners' Forum were as interesting and educational as the first. Notable was the frank and open discussion of challenges and differing opinions, as well as the diversity of speakers and participants, which ranged from captains of industry to academic thought leaders, and from ministers in African governments and senior officials in the US government through to front line workers in the field.  I particularly enjoyed seeing partners from India and Africa wearing traditional dress - not everyone wore dark suits!

The highlight was the final interview with Bill and Melinda Gates that closed the conference.  This was the first time since joining the Foundation that I'd had the opportunity to see them in action.  Bill spoke with excitement about a large new surveillance program the foundation is funding, CHAMPS, to better understand the causes of child mortality in developing countries.  Melinda was very eloquent and passionate as she spoke about her priority to empower women and girls as a fundamental means to achieve Global Health goals.  It was amusing to see them interact as a couple on stage.  At one point Bill likened the UN Sustainable Development Goals, which had been roundly criticized for their length earlier in the meeting to the Bible, pointing out that it's all good stuff but all you really need to know is the ten commandments.  Like any wife would do, Melinda warned him not to push the analogy too far!  More humor ensued when the moderator, NPR's Arun Rath asked how the Gates manage to influence governments when others fail - do they just ask more nicely? Bill responded that some governments he deals with haven't yet built any bureaucracy and don't have any bureaucrats he can speak to, whereas globally we have plenty of bureaucracy.

Today, after the partners had all departed, I was impressed that the Foundation leaders held a lunchtime session for staff to debrief on highlights and lessons learned from the Forum. All the sessions were video taped so that people who couldn't attend in person will get the benefit of hearing all the inspirational speakers.  Bill Gates Senior attended the lunchtime session and commented how the Forum had helped him appreciate the enormous importance of addressing global health issues and given him the confidence that it is possible to have positive impact through the work of the Foundation.  The Foundation first began at Bill Senior's urging 15 years ago by supporting US education and libraries and later moved into Global Health.

I'm now six weeks into my first three months and feeling like I've attained first base, having seen Bill, Melinda and Bill Senior in action, met most of my colleagues and many of the external partners I'll be working with. Time to enjoy the weekend, particularly as Jonathan is here on his first ever visit to Seattle, and the sun is shining!

Global Partners' Forum Day One

Today has been inspirational and slightly mindblowing.  The Foundation has convened its annual 'Partners Forum' with a thousand experts in Global Health who are advisors or receive grant funding converging in Seattle.  I listened to keynote presentations and panels with giants including Peter Piot, one of the discoverers of Ebola in Zaire in 1976, Bill Foege, a major player in smallpox eradication, and Ewa-Marie Coll-Seck, Minister of Health for Senegal, and hob-nobbed with pandemic flu expert Fred Hayden, who has recently turned his attention to ebola. The day was filled with those wonderful random encounters when everyone you sit next to has an interesting story to tell.  I learned about neglected tropical diseases including lymphatic filariasis and sleeping sickness, and about nutrition - who knew that you have to blanch or boil carrots to solubilize the vitamin A so it can be absorbed, and that too much spinach can cause inflammatory changes in your lower intestinal microbiome - iron supplements are much safer as they are absorbed higher in the alimentary tract.

Most inspiring were the many speakers from Africa who eloquently described the health needs in their countries.  There were many surprises - I didn't know that Rwanda is held up as a model of health systems, with early adoption of new vaccines for national immunization programs and high uptake of family planning. Senegal and Zambia are also spending a considerable portion of their GDP on health systems.  An old friend from Uganda, Alex Coutinho, who was Director of the Infectious Diseases Institute when I worked there in 2012, and now has joint appointments at IAVI and Makerere University, was there.

I am looking forward to see what then next two days of similar meetings will bring.

A Day in the Life at the Foundation

Today was a typically busy day.  I had two calls this morning with different pharma companies that are applying for Foundation funding, and then headed downtown in the afternoon for the start of the Foundation's annual 'Global Partners' Forum' where over 1000 grantmakers and grant recipients will meet, mingle, and listen to the latest strategy and new initiatives from our executive management, culminating in a discussion with Bill and Melinda on Thursday morning. That will be the first time I will get to see and hear then in the flesh!  These are great opportunities for me to meet more of my colleagues, both internal and external to the Foundation, while I'm in Seattle. Soon I will be half way through my initial three month sojourn here.

One colleague has just returned from a business trip to Indonesia - to Jakarta to visit a clinical trial site and then to Bali for a conference. I have some travel coming up for meetings in New York and Washington DC - important but not quite as exotic!

I took advantage of another Foundation amenity this morning - I am suffering from an inflamed tendon due to too much walking at the weekend, and not only did I manage to get an appointment at the free on-site clinic, but they had a supportive walking boot-brace in exactly my size! I laughed my footwear off today (May the Fourth) as an attempt at a Darth Vader costume but need some more humorous ripostes to get me through the rest of the week, or maybe I'll just wear very long trousers and hope no-one notices.

Compline

On Sunday evening I headed over to St. Mark's Cathedral on Capitol Hill, a large square building with a distinctive minimalist 'rose' window that overlooks Lake Union.  You can see it clearly from the Foundation.  St. Mark's is famous for its sung Compline service, founded in 1955 by Peter Hallock, who still sings in the 18 male voice choir.  The sound was superb, echoing throughout the space. In the early years the choir sang to an empty church, but as flower power took hold in the 60's it began to attract a young hipster crowd and they're still going strong today, turning up in droves with blankets and quilts that they spread on the floor and then lie back upon, to gaze at the ceiling and soak up the sound. Never mind that there was plenty of space to be had sitting in the pews...The smell of pot seems ubiquitous in Seattle and was particularly noticeable on the bus going up Capitol Hill as well as among the congregation.

Ballard and Fremont

Today's peregrination took me to the Sunday Farmers' Market at Ballard.  I arrived just as the market opened and had my pick of the produce - fresh baby lettuces, arugula and rose-pink radishes, blue oyster mushrooms, a bunch of lilacs, bluebells and apricot tulips, organic eggs, beef and bacon and a jar of wildflower honey. Is your mouth watering yet?   There were some other intriguing goods and services on offer including a stall that sold edible wild plants including lady fern fiddleheads, seabean (a kind of very salty samphire), morels and nettle leaves, and a poetry stall where who name the topic and the price and they conjure up a poem and type it out for you on a very old fashioned typewriter while you wait.  There were all kinds of beverages on offer from kombucha to hot cider toddy; I settled for a lavender latte with green tea and black sesame shortbread cookies. Entertainment was provided by numerous buskers, most of them on guitar but including two enterprising young boys on penny whistle and concertina.  And there were dogs everywhere. Seattle famously has more dogs than children per family.

After enjoying the delights of Ballard I hopped aboard a bus back to Fremont, the neighboring community whose motto is 'De libertas quirkas' or 'Freedom to be peculiar'. The Ship Canal borders both Ballard and Fremont to the south, and Fremont has a pretty orange painted swing bridge across the canal that gives right of way to water traffic so opens and closes frequently.

Fremont has a number of art installations including a huge concrete troll lurking beneath a road bridge, a controversial and massive Bulgarian bronze statue of Lenin and a couple of aluminum statues of people waiting for (or running for) a tram. There's also a rocket ship (I think a repurposed Boeing  aircraft turned on end).

I took one of the Seattle stairway walks from the book of the same name in Fremont. I have to say it was a bit masochistic as the suggested route perversely wound back and forth, up and down the hill, with seemingly no other purpose than making the walker climb as many steps as possible just for the fun of it.  The views from the top across the Ship Canal to the distant Olympic mountains were admittedly spectacular as it was such a clear day, but my foot was hurting and my flowers were starting to droop by the time I got home.

Exploring West Seattle

Today's adventures took me to Alki Beach, which was one of the earliest pioneer settlements here. Its, original name was New York-Alki which in the local Indian dialect meat (optimistically) New York - pretty soon. When the settlers - including the Borens from Illinois, Lows, Bells and Dennys landed by ship from Portland, Oregon in November 1851 they relied on local knowledge from the Indian Dumamish and Suquamish peoples to survive the first two winters, including feeding their infants clam broth as they couldn't bring in a milk cow by boat.

I walked downtown and ducked behind Pike Place market down Post Alley, whose walls are covered with an accretion of used gum, every color of the rainbow. Gross yet artistic.  The alley runs downhill behind Pike Brewing Company - it was interesting to peek into the 'business' areas of the brewery that are not open to the public.  There is a tremendous amount of construction going on down by the waterfront, most of which was cordoned off.  I just managed to catch the water taxi (they saw me running down the gangplank and waited) across to West Seattle, which provides great views of the Space Needle and the big wheel from Elliott Bay.  The piles at the dock were covered in a more pleasant accretion of mussels and barnacles,

Alki is beautiful - the views across Puget Sound reminded me of  the Coromandel peninsula in New Zealand. I sauntered through the College Street ravine which was filled with wild roses and bluebells, and later on, through the Schmitz Preserve, which is one of the few places in Seattle where the old growth trees remained, having been saved from logging by the steepness of the ravine.  I took a loop up and across the creek, which was periodically criss-crossed by fallen logs, their trunks mossy with age with ferns growing up around them.  The beach has a long strip of sand with driftwood logs that you can sit on, and further up changes to pebbles.  A few children ventured into the water but most people sat sunning themselves.  There were a handful of divers in heavy wetsuits and rubber gloves by the water taxi dock - I wondered if they were looking for clams or other marine life.  Apparently three pods of orcas, 88 animals live in Puget Sound, but I didn't spot any today, nor did I see any seals or porpoises.  The weather was glorious and I realized when I got home that my cheeks had caught the sun.

Big Data

My day began with a 1:1 meeting with Trevor Mundel who heads Global Health at the Foundation. The conversation turned to scenarios and forecasting and I learned about Chris Murray at the Institute of Health Metrics and Evaluation, a visionary who has led the establishment of a global model of disease burden.  I'm looking forward to reading Chris's recently published biography, 'Epic Measures'. You can visit the IHME website to play with amazing interactive visualizations of disease patterns and causes of death of men and women of all ages around the world.

The statistics on causes of disease and death are gathered from various local sources in each country and often require trickery such as Bayesian statistics to fill in the gaps. For example in many countries HIV deaths are often not reported as such, so the 'official' data must be interpreted accordingly based on assumptions about HIV prevalence from antenatal screening and other health programs.  IHME is constantly adding new data and refining the model to go from historical reporting to forecasting future patterns of disease and layering in additional factors including socio-economic, environmental and others.  The biggest contributions to reducing infant mortality include increased personal income, lower birth rates, better nutrition and education of mothers as well as innovations in treatment and healthcare systems. Shockingly, the factors that are driving increases in death rates among adults in the developing world include the spread of HIV / AIDS, tobacco use, the obesity epidemic and alcohol abuse.