We don ’ t just need precision medicine ; we need precision health

It was 7:15 on a Tuesday evening in early September, and Irving Weissman, MD, needed a birthday cake, stat. His daughter, Rachel, was turning 22 the next day. Fresh from fishing the Bitterroot River, clad in khakis and a long-sleeved beige shirt and in stocking feet, he picked up the phone to begin cajoling a local bakery to rustle up a cake big enough to serve several dozen people. “You’d think no one in this town wants to make any money,” he said, with a wry smile, after being politely rebuffed. Clearly, the rules in Hamilton, Montana, are a bit different than those in Palo Alto, California. Undaunted, Weissman, 76, the director of the Stanford Institute for Stem Cell Biology and Regenerative Medicine, dashed outside to confer with caterers slow-cooking three large prime rib roasts on the ranch’s patio. Could they make a cake by tomorrow? Inside, several groups of people sat on couches or discussed their research at tables in the corner of the large living room. Normally, the room sports a floor-to-ceiling view of the stunning Como mountain peaks, known locally as the Three Sisters. But that evening they were obscured by thick smoke from surrounding forest fires still raging in parts of the state. Weissman, who also directs the Ludwig Center for Cancer Stem Cell Research and Medicine at Stanford, had invited more than 30 members of his laboratory and the lab of his former student Judith Shizuru, MD, to Montana for an annual scientific retreat at the ranch he co-owns with fellow scientists and longtime friends David Baltimore, PhD, and Leroy Hood, MD, PhD. Earlier that day, attendees had presented their research at the nearby Rocky Mountain Laboratories, where lethal diseases such as Ebola, influenza, plague and the lesserknown Rocky Mountain spotted fever are studied. The next day, they would be given the chance to don the protective gear used by researchers at the biosafety level-4 laboratories for a photo opportunity to commemorate their visit. The yearly gathering has been a tradition since 1992. But Weissman’s Montana roots go much deeper.