Kim Solez 204 years of banff spirit9 new february 12 2019

Kim Solez World Exponential Timeline
From Homer Smith 1895 to Aug. 7, 2099
1934 Leonard
Cohen
1941 Paul Simon 1945 Rod Stewart 1991 Ed Sheeran
1994 Mallory Chipman
1901 Louis
Armstrong
1920 Robert
Heptinstall
1943
Janis
Joplin
1961 Peter
Diamandis

Think Different
It is different to mix
science, music, and
poetry together as
we have done in this
presentation!

Think Different – Kim Solez sharing
cyberNephrology 5B3.09 WCM HSC with
Students & Fellows
Annette Shaff / Shutterstock.com

204 Years of the Spirit of Banff 1895-2099 122
Back 82 Forward

Homer Smith, born 1895, turned Kim on to the
kidney in med school 3rd yr.

Homer Smith born 1895 Turned me on to
kidney in med school 3rd year .

Louis Armstrong, born 1901, Turned Kim on to
the trumpet and jazz.

Robert Heptinstall was Kim’s mentor in kidney
pathology.

Solez, Morel-Maroger, and Sraer
Medicine 58:362-376, 1979. Morphology
of "acute tubular necrosis" in man:
Analysis of 57 renal biopsies and
comparison with the glycerol model. My
most cited paper before coming to
Edmonton as Chair of Pathology.

Medicine 58:362-376, 1979
1. Of the 12 lesions assessed in the 57 “ATN”
biopsies 10 persisted after functional
recovery. Only 2 lesions correlated with
function, were present when renal failure
was present and absent after recovery:
1)thinning of PAS positive brush border, & 2)
shedding of individual tubular epithelial cells
leaving bare basement membrane.

Medicine 58:362-376, 1979
2. Lesions which persisted after recovery of
function included tubular dilation, regeneration,
mitoses, casts, interstitial edema, inflammation,
nucleated cells in vasa recta, dilation of
Bowman’s capsule, tubularization of Bowman’s
capsule epithelium, & juxtaglomerular
apparatus hyperplasia. The latter two were
more prominent in recovery biopsies.

Medicine 58:362-376, 1979
3. Lumping all acute tubular injury lesions
together guarantees that histology assessment
will appear to be inferior to molecular
assessment, since the majority of ATI lesions
persist after functional recovery. Only studies
which separately assess the two lesions which
correlate functionally are valid. i.e. 1)thinning or
absence of PAS positive brush border, & 2)
shedding of individual tubular epithelial cells .

Paper still referred to in recent reviews,
findings uncontested.
Basile et al., 2012

Cannot say molecules change faster than
morphology until you look at these two
lesions, BB loss and cell exfoliation!
Basile et al., 2012

Heptinstall called the 1979 paper ”the
best that can be done with a difficult
subject!”

Later work on Transplant Acute Tubular Injury
Was an Important Antecedent to Banff Studies
1993 KI paper on Transplant ATI.

New insights into transplant ATN, Solez et al. 1993
Brush border loss not a feature of transplant ATN.

Forty years later a more nuanced
understanding of the post ischemic kidney
is that tubular injury and microvascular
injury are separable components which
can be influenced in opposite ways by
pharmacologic interventions. Both types
of injury contribute to renal functional
impairment. These issues are the subject
of major precision medicine initiatives
which should bear fruit in 2019-2020.

Leonard Cohen, born 1934, turned Kim on to
poetry and his style of music

Nine months after meeting Kim Solez over 3 day
weekend in 2005 Leonard wrote song inspired by
their discussion of Banff borderline changes.

Ten years later Leonard removed all but one of the
borderlines and the song became the popular
“Treaty” on the 2016 You Want It Darker album.
“I wish there was a treaty we could sign
I do not care who takes this bloody hill …
I wish there was a treaty we could sign
It’s over now the water and the wine
We were broken then but now we’re borderline
I wish there was a treaty
I wish there was a treaty
Between your love and mine”
The notebook pages showing this ten year song transition were the
only such pages reproduced in the program for the “Tower of Song”
Tribute Concert in Montreal at the Bell Centre November 6th, 2017.

Paul Simon, born 1941, has inspired Kim with
his lyrics for a long time

Janis Joplin, born 1943, inspired Kim and was a
friend of Leonard Cohen

Rod Stewart, born 1945, inspired
Kim Solez and Lorraine Racusen

Kim Solez, born 1946, already plotting things at
age 3 seen here with father.

His first memory of event impacting outside world,
age 7: Hearing Queen Elizabeth Coronation on
Radio in 1953

The Origin of Kim’s Diversity Beliefs at Age 7,
Yasmini.

Ray Kurzweil, born 1948, co-founder of Singularity
University, is Kim Solez’s most important technology
influence.

Peter Diamandis, co-founder of Singularity
University born in 1961, is an important technology
influence.

Ed Sheeran, born in 1991, is an important
musical influence on Kim.

Banff Transplant Pathology
Classification Began at The
TransCanada Pipeline Pavilion at the
Banff Centre for Conferences in 1991

Banff meeting slide box mentioned in
first Banff abstract in 1991 is in itself
also an important player in story .

Ironically the last Banff classification
workshop in which these slides were
used was in 2004 in Aleppo, Syria.

Visit to Cuba in February 1998 influenced me
and provided a counterpoint to my alter ego
intensivist David Crippen’s visit there in 2018

Mallory Chipman, born 1994, is an
important musical collaborator in
technology&Leonard Cohen events!

Kim&Mallory initiated Technology&All
That Jazz Project to broaden the reach
of important ideas in science.

So where will it end? The farthest
future date in song Kim Solez can
conceptualize is Aug. 7, 2099

We have ended the timeline with Aug.
7, 2099, and will create an event page
but then again there is also this song!

So maybe we have to push our
imaginations to 5555. Kim Solez can
imagine that Banff will still be
remembered in 2525, but not in 5555!

Pennan, Scotland near Banff is where
classic 1983 movie “Local Hero” was shot

Kim Solez with meeting coordinator Michele
Hales in 2002 in Pennan.

2003 image from Aberdeen Banff meeting.
Lorraine Racusen is in the center and
Michele Hales is beside her. Phil Halloran is
behind Michele. Jake Demetris is at far left.

Tori Sheldon and Akshatha Raghuveer. In 2007 we
lost our funding from the NKF and student staffing
began.

Many students have contributed
extensively to Banff meetings.

Video has become an important part of
meetings, Patricia Bacus, Banff 2017

Nikki Olson was important part of early video
efforts and creation of Tech&Future of Medicine
course

Laurie Bennett also provided early videography
assistance to Kim Solez

In recent years Tatiana Zagorac has become
main videography advisor to Kim Solez

Another important local hero is the local
Banff meeting director, like Daniel Seron in
Banff 2017. The subject of another ppt!

In 1991 Kim Solez and Lorraine Racusen Directed the First Banff Meeting
Which Created the Banff Classification of Transplant Pathology and Banff
Consensus Process
Classification established, lesion scoring,
diagnostic categories, physician-led consensus

BANFF CLASSIFICATION STANDARD FOR
TRANSPLANT BIOPSY INTERPRETATION
Began in kidney (Solez et al. 1993), and was then extended
to liver, pancreas, composite tissue grafts etc. Meetings
also consider heart, lung, small bowel.
Uses semiquantitative lesion scoring 0-3+ and diagnostic
categories. A pathologic classification of all pathologic
changes, not just rejection.

1993 Meeting was joint with Canadian
Association of Pathologists – Future
Consortium was Important Antecedent
1993 Meeting - Liver classification, chronic rejection, first presentation on
molecular pathology approaches, CAP Future of Pathology Consortium consensus discussions
1988-94 were an important antecedent to Banff consensus discussions .

1995 Banff meeting at Banff Centre for
Conferences Group Picture of Liver Attendees

1995 Shot - Bruce McManus in Center, Pekka Hayry
Behind, Fred Sanfillipo in Doorway - Who Else Can
You Identify?

More 1995 Shots
Kim Solez and Lorraine Racusen
1995 Meeting - Pancreas classification, glomerulitis, first international medical meeting on
CD-ROM, first Banff conference with microscope sessions. Lesion scoring normalized with CADI.

1997 Meeting – Banff Springs Hotel
1997 Meeting - Merging of Banff and CCTT classifications, establishing basis for current Banff
classification, post-transplant lymphoproliferative disorder, first Banff conference with posters.

1999 Meeting - Larry Hunsicker,
Agnes Fogo, and Elaine Solez
1999 Meeting - Protocol biopsies, chronic rejection, and viral diseases, clinical practice guidelines.
First conference supported by an NIH grant.

1999 Meeting – Michael Kashgarian and Agnes
Fogo
First conference supported by an NIH grant.

1999 Meeting – Glomerulitis Study Group with
Kiril Trpkov
First conference supported by an NIH grant. Glomerulitis study group.

1999 Meeting – Agnes Fogo

1999 Meeting – Larry Hunsicker,
Elaine Solez, and Agnes Fogo

2001 Meeting – Larry Hunsicker,
Agnes Fogo, Kim Solez and Bob Colvin
2001 Meeting - AMR, donor biopsies, genomics, CAN, heart transplantation

2001 Meeting – Parmjeet Randhawa and
Volker Nickeleit

2001 Meeting – Peter Furness

2001 Meeting – Lorraine Racusen

2001 Meeting –
David Rush and Denis Glotz

2003 Meeting –
J. Stewart Cameron and Andrew Rees
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

2003 Meeting –
Andrew Rees

2003 Meeting –
Doug Wilson

2003 Meeting –
Sony Aibo Robotic Dog

2003 Meeting –
Michele Hales and Janice McDonald

2003 Meeting –
Lorraine Racusen and Family

2005 Meeting – Phil Halloran, Ginny Halloran,
Vido Ramassar
2005 Meeting - Genomics and molecular markers, B cells, chronic allograft injury with
elimination of CAN, establishment of criteria for chronic rejection.

2005 – Janice McDonald, Charlene Hunter,
Banu Sis, Michele Hales

2005 – Kim Solez and Banu Sis

2007 Meeting – Michele Hales and Eduardo
Martul
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas

2007 Meeting – Kunio Morozumi and Michael
Mihatsch
composite tissue rejection schemas.

2007 Meeting – Banu Sis

2007 Meeting – Ian Gibson

2007 Meeting – Roz Mannon

2007 Meeting – Michael Mengel

2007 Meeting – Eduardo and Lorraine

2007 Meeting – Nikki Olson and
Kim Solez

2007 Meeting – Tori Sheldon, Nikki Olson and
Paula Blanco

2007 Meeting – Tori Sheldon and
Nikki Olson

2007 Meeting –Nikki Olson

2007 Meeting –Eduardo and
Lorraine and Richard Racusen

2007 Meeting – Dinner in Castle, Nikki Olson,
Tori Sheldon, and Bob Colvin

2009 Meeting – Jubilant Tori and Akshatha
Return to Edmonton!
2009 Meeting - Viruses, quality assurance, AMR in kidney, heart, and pancreas, liver allograft
accommodation, endothelial cells, surrogate markers. Working groups.

2009 Meeting – Lorraine Racusen and Michael
Mengel

2009 Meeting – Mark Haas

2009 Meeting – Jubilant Dar, Akshatha and Tori
Head Back to Edmonton!

2011 Meeting – Larry Hunsicker, Agnes Fogo,
and Kim Solez
2011 Sensitized patient, C4d, isolated v-lesion, the future, genomics, glomerulitis, epithelial injury
/epithelial mesenchymal transformation, operational tolerance monitoring in liver grafts.

2011 Meeting – Banu Sis Isolated V
2011 Sensitized patient, C4d, isolated v-lesion, the future, genomics, glomerulitis, epithelial injury
/epithelial mesenchymal transformation, operational tolerance monitoring in liver grafts.

2013, 2015, and 2017 – Recent so you have
your own favorite images!
Kim Solez’s favorite image from Banff 2017 capturing the spirit of Banff!

Banff 2019 and 2021 will be in Pittsburgh, USA and
Banff, Canada. Banff 2019 will have a regenerative
medicine/tissue engineering themed pre-meeting.
New Kinnear Conference Center holding 470 people at the Banff Centre for Conferences!

From Kinnear Centre Where We Will Be in 2021 Can
See TransCanada Pipeline Pavilion out the Window!
Can see our original site for Banff 1991, 1993, and 1995 out the window!!

It Was Always the Intention that Banff Would
be Digital, Portable, Morphometric, AI Based.
Can see our original site for Banff 1991, 1993, and 1995 out the window!!

Banff Has Progressed As Far As It Can in the Low
Tech Route. Future Major Advances Will Require
High Tech Approaches: Digital Path /Artificial
Intelligence/Genomics/Regen Medicine.

Applications of AI in Medicine

AI and Pathology Came Together in April 2017 FDA
Approval of Digital Pathology for Primary Diagnosis

In 2018 the First Ever Digital Pathology and AI
Congress in New York City

I recruited Digital Pathology expert Yukako Yagi to
joint UAlberta/Univ. Pittsburgh position in early
1990s!
Now at Memorial Sloan Kettering, she was one of keynote speakers at
2018 Digital Pathology and AI Congress.

Almost Overnight Pathology Went From Having
the Worst Promotion of Any Specialty to the
Best. We became the Hollywood of Medicine!

Gone Are The Blood And Guts. Now Every Page
is Visually Appealing and Seductive!

Every Effort Is Made to be Reassuring and
Comforting.
“AI pathology is never going to
replace pathologists.”
“Nobody should feel threatened by
advances in computational pathology.”
“The integrative aspects of pathology,
the cognitive abilities of pathologists,
and the collective wisdom generated
over many years as a community
cannot be replaced by a machine.”

These statements are only true near term, not
forever:
“AI will really help enrich your ability to
practice pathology and improve your
ability to serve your patients.”
“AI is not here to remove pathologists
from the decision-making process.”
“(AI is) an exciting step forward in the
discipline of pathology – one that puts
pathologists at the very center of clinical
care and precision
therapeutics.”

Pathologists Will Remain Central Only So Long As They
Add Value To The Process. And about being replaced:
Bertalan Mesko - The Medical Futurist
states it correctly:
“AI will not replace physicians, but
physicians using AI will replace
physicians not using AI.”

All Five Reasons in this Online 2018 Article are
Unsupported & Incorrect:
Bertalan Mesko - The

All Five Reasons in this Online 2018 Article are
Unsupported & Incorrect:
Bertalan Mesko – The Medical Futurist incorrectly
states that:
1. AI cannot be empathetic.
2. AI cannot do nonlinear thinking.
3. Machines cannot interpret data.
“No robot or algorithm could clearly interpret complex, multi-
layered challenges – involving the psyche. While they will
provide the data, interpretation will always remain human
territory.”
https://medicalfuturist.com/5-reasons-artificial-intelligence-wont-replace-physicians
4. There will always be tasks like the Heimlich maneuver algorithms and
robots can never complete.
5. Human machine cooperation is the ultimate solution. There is
nothing better.

New Finnish Government AI course
www.elementsofai.com Says We Do Not Need to Fear AI
because Self Improvement Requires Human Help.
“… even if a system could optimize its own workings, it would keep
facing more and more difficult problems that would slow down its
progress, quite like the progress of human scientists requires ever
greater efforts and resources by the whole research community and
indeed the whole society, which the … entity wouldn’t have access
to. … human society still has the power to decide what we use AI
technology for. (With progress in AI we become)…better at controlling any
potential risks due to it.”

Machines Will Be Able to Create Their Own Models of
the World but Humans Will Want to Get a Word in
Edgewise!
https://www.theguardian.com/books/2018/jun/15/rise-of-the-machines-has-
technology-evolved-beyond-our-control-

Machines Will Be Able to Create Their Own Models of the
World but Humans Will Want to Get a Word in Edgewise!
"Google Translate was known for its humorous errors, but in 2016, the system
started using a neural network developed by Google Brain, and its abilities
improved exponentially. Rather than simply cross-referencing heaps of texts, the
network builds its own model of the world, and the result is not a set of two-
dimensional connections between words, but a map of the entire territory. In this
new architecture, words are encoded by their distance from one another in a mesh
of meaning – a mesh only a computer could comprehend."
• https://www.theguardian.com/books/2018/jun/15/rise-of-the-machines-has-technology-evolved-
beyond-our-control-

Fictional Worlds Presented to Sentient AI As Fact
Threaten Humanity’s Survival
AI Will be Sensitive to Lies About Itself

Fictional Worlds As Models of the Real World Exist
Already in 2018-2019 and Will Increase in Number and
Influence

YouTube channel www.youtube.com/user/kimsolez
explores pathologist/AI interaction and tissue
engineering pathology influence in the future. Rate
of subscription increased six fold in 2018!
New Kinnear Conference Center holding 470 people at the Banff Centre for Conferences!

Areas of shared interest for Kim Solez/Ishita Moghe
the subject of presentations in November 2018-
February 2019
• Medicine Before Medical School, Infectious Youth,
Agency, and Reimagining Future Communication: What If
the Secret of High Impact, Awesome Recruiting, and the
Fountain of Youth Have Been Hiding Right in Front of Us
All Along.
• Yuval Noah Harari, Fulfilled Reality, Multithreading,
Bucket Lists, and What We Will Use That Extra Intellect
for in the Future
• Precision Medicine

Do We Have Agency? Can We Make Change?
In Previous Eras It Took Years to Decades to
Effect Change Via Journal Articles and Books.
In Banff Classification, we are still
struggling with borderline changes after 27
years. Discussed with Leonard Cohen in
2005, became the song “Treaty” 11 years
later. Isolated v lesions discussed as
evidence for rejection for 6 years.
Interaction stylized documented, and
formal. Slow, but you knew who influenced
what.

In 2019 We Have Agency, But Proof Is Lacking Who
Influenced What. As Instances Accumulate Evidence
Becomes Convincing. Timeline 2 days to 6 months.
Much Faster than Before! Formal Documentation
Lacking. Three Examples. #1
Instance #1 Human Cell Atlas Project (HCAP) at
ASN Meeting.
Oct. 29, 2017 “Blind-sided by the future”
message posted to Facebook complaining about
exclusion of HCAP from mainstream meetings.
Oct. 31, 2017 HCAP scientist and nephrologist
Benjamin Humphries appointed Chair of Program
Committee for 2018 ASN Meeting. March 31,
2018 YouTube video describing Moghe-Solez
paradox of exclusion of such subjects from
mainstream meetings,
https://www.youtube.com/watch?v=dAb6EpwpE
kM
August 2018 Aviv Regev plenary presentation on
HCAP at 2018 ASN meeting announced, in Kidney
News received in Sept.

What a great moment it was to hear Aviv
Regev’s ASN Plenary talk the end of October
2018 after all the anticipation and talk with her
afterward!

Instance #2 Sept 15th, 2018 Yuval Noah Harari Claims humans will
be stuck, all plot lines wrecked when machines do all crucial
decision making.
https://www.theatlantic.com/magazine/archive/2018/10/yuval-
noah-harari-technology-
tyranny/568330/?fbclid=IwAR2WjyHq_srFD4Zg_Wop-
3emHbWLpQRvtrgr5qW04cqRm_X8f1GpEzzYFw0
Sept 21, 2018 Our multithreading video points out humans will
adapt, culture could be many-fold better than today with
multithreading.
https://www.youtube.com/watch?v=wL2rL8LPfQM
Oct. 4, 2018 In his Wired interview Harari now says human
reaction to machine decision making is work in progress, no
predictions can be made! https://video.wired.com/watch/yuval-
harari-tristan-harris-humans-get-
hacked?fbclid=IwAR1soHWIpmVz8P9HITPzd5Bdl2mYOy-
nXOe272x-6Eh5ufKVet5XXp_RmQU

In his wired video interview Harari advises that individuals can accomplish very little by
themselves. They should join groups, causes, he says. That is the opposite of our experience
doing videos together where we seem to be accomplishing a lot without joining groups.

May 24, 2018. Directly contradicts author’s own
book from October 2017. July 20, 2018 video
supports same ideas
https://www.youtube.com/watch?v=a1QguDFMBM
8
https://medicalfuturist.com/5-reasons-artificial-intelligence-wont-replace-
physicians?fbclid=IwAR0QeJYTbP-HRCndFXvR5glr1AR2fdTVGfc1t6fO-i-EOZ1F_77oJtw7YB0

We Directly Contradicted the May 24 July 20th 2018
posts in series of videos from Aug. 20 to Oct 11th.

On October 22, 2018, 11 days after our last video,
Bertalan Mesko posted new video that agrees with us!
https://www.youtube.com/watch?v=hT0ly4pDSoY.

October 22 Bertalan Mesko video that agrees
with us does not mention us!
https://www.youtube.com/watch?v=hT0ly4pDSo
Y.

Taken together these three examples suggest our
videos are accomplishing major things, have agency.

Short time frame, days to weeks, in these effects
suggests a new model of science communication.

Images from Ishita Moghe Talk Gamification to
Incentivize Computer Data Entry November 22, 2018 .

Previously I Only Knew Students’ Thoughts About Course
Through Feedback Questionnaire, but in Dec. 2018
Spontaneous Positive Outpouring. Ishita Moghe Lectures
Seemed Like Only New Element to Account for This .

Medical Grand Rounds Presentation
February 1, 2019:
Seizing the Opportunity of
Technology and The Future of
Medicine
Kim Solez, MD & Ishita Moghe, BSc
CREATING A POSITIVE
MEDICAL FUTURE FOR
EVERYONE

My mentor Robert Heptinstall was immensely
pleased with the Winter Term students in Jan. 1973,
encouraged me to repeat program in future years.

Student-Driven Innovation
● Creation of ‘Nephrology Immersion’
(2018)
● Creation of the LABMP 590 Course
(2011-present)
○ Tissue-engineering pathology
○ Ethics of the future

Art Conveys Important Messages of Science -
Enhances Technology Acceptance
● Doctors’ Dining Room in 5B WCM
HSC after Lab moves to Hub?
● Future and All That Jazz
● Tuesday Night Poetry at the Nook
Café

The Future &
All That Jazz
Message
Dr. Rich Sutton’s Views
on AI Safety
Acceptance. Share power.
AI will compete and cooperate
with us just like other people,
except with greater diversity and
asymmetries.
Step 1: Lose your sense of
entitlement
Step 2: Include AIs in your circle
of empathy

Moore’s Law Predicts Singularity

We Could Eliminate All Disease and Still Have A
Terrible World!
● The challenge of friendly AI becomes just a small part of a
much larger challenge of creating a friendly world in which
humans still have lives of significance, human history is
retained and extended.
● We all need to be engaged in ensuring a positive outcome for
humanity. The future is ours to shape. We need to get busy
doing that!
● Part of the imagined future could be one
where all disease was eliminated but life
was intolerable. Another where the only
diseases are from bioterrorism.

2045 is only 26
years from now.
Many of you will still
be working then.
What will medical
careers be like then?
● Man-made diseases
● Bioterrorism
● Human enhancement
● Social responsibility

• “It is the curse of humanity that it learns to tolerate even the most
horrible situations by habituation. Physicians are the natural
attorneys of the poor, and the social problems should largely be solved
by them.”
-Rudolf Virchow
Rudolf Virchow on the Social Responsibility of
Medicine

Source: AAMC Center for Workforce Studies, June 2010
Analysis

Digitization in Medicine Can Help Prevent
Burnout
● Pathology and AI came together
in April 2017 FDA approval of
digital pathology for primary
diagnosis
● (Cytology, Frozen Sections, and
Hematopathology were excluded
from approval.)
● Push Connect Care Epic/Beaker
to be the best of the best EHRs
● Rather than burden physicians,
EHRs in the future should
augment patient care

Taken together, the three examples
suggest our videos are accomplishing
major things, & that we have agency.
Do We Have Agency? Can We Make Change?

Kim Solez 204 years of banff spirit9 new february 12 2019

Recommended

Recommended

More Related Content

Similar to Kim Solez 204 years of banff spirit9 new february 12 2019

Similar to Kim Solez 204 years of banff spirit9 new february 12 2019 (17)

More from Kim Solez ,

More from Kim Solez , (20)

Recently uploaded

Recently uploaded (20)

Kim Solez 204 years of banff spirit9 new february 12 2019