New episode with Dr. Tom Oxley, co-founder and CEO of Synchron. Synchron has built a BCI called the Stentrode, which reaches the motor cortex via a blood vessel — leveraging the approach of cardiovascular stents, without having to open the skull at all!
15 million people live with motor impairment. The Stentrode lets people operate their phones and computers through thought, and could restore independence to people who’ve lost the ability to control their devices. Tom sees BCIs as a major technological leap that will help human flourishing, by enabling better communication, decoding and conveying emotions, and enabling us to leverage the great capabilities of our computing infrastructure.
This was a great, wide-ranging conversation. We discuss the origins of Synchron, the endovascular approach and its benefits, their next-gen system designed for high-channel-count recordings across distributed brain regions, the longer-term possibilities of helping people communicate better, how Tom developed as a founder and how he leads the company, how BCIs could unlock powerful mental states similar to psychedelics and meditation, how neurotech will transform humanity in the 2030s and 2040s, and why Tom thinks the US will lose the BCI race to China unless the US greatly accelerates. Hope you enjoy!
Links to this episode and references below.
Topics Covered
00:00:00 Introduction
00:03:18 Carl Jung, stroke surgery, and the road to BCI
00:06:58 The endovascular approach: reaching the brain without surgery
00:10:37 Getting Synchron off the ground
00:17:23 Reading the brain: channels, signal, and noise
00:36:41 The numbers: 15M patients, FDA, and Medicare
00:43:17 Cognitive AI: foundation models, the data economy, and the 2040s
00:52:55 Consciousness, psychedelics, and the extended self
01:02:51 Agency, addiction, and geopolitics
01:06:51 The optimistic vision: unlocking the subconscious
01:10:49 Building a company: 696 no’s
01:21:30 Losing the BCI lead to China
Other Links to the Podcast
Links From the Podcast Episode
Guest + Organizations
Research Papers + Technical References
“Neuronal ensemble control of prosthetic devices by a human with tetraplegia” (2006)
Meta open-sourced sEMG (neural wristband) datasets at NeurIPS 2024
References Mentioned in Conversation
Books + Media
Links
Transcript
Juan Benet
So my guest today is Tom Oxley, MD PhD. He’s the founder of Synchron, a BCI company developing an endovascular implant, the Stentrode. He studied neural engineering and medicine at Melbourne and neurosurgery at Mount Sinai Hospital. He has performed over 1,600 endovascular neurosurgical procedures, which is amazing. He has published over 120 peer-reviewed articles and journals, filed over 100 patents. He’s also a professor of medicine at the University of Melbourne, and I’m sure other accolades as well. Honored to be here speaking with you and very excited about all of the tech that you’re building. Thanks for coming on.
Tom Oxley
Thanks, Juan. Happy to be here.
Juan Benet
So let’s just talk about neuroscience and neurotech in general. When you think about neuroscience or neurotech, like whichever angle you want to pull it apart from, like what do you find interesting about the broad field, like what are the kind of core questions that you find motivating in the field?
Tom Oxley
How the brain works, still talking about how the brain works. Last 20 years a lot of non-invasive imaging studies trying to piece together elements of functional localization in the brain, a lot of systems neuroscience work, a lot of computational work, and then still a lack of a cohesive model that brings everything together. That was probably the inspiration that got me originally interested in the field, and then how that generates the experience of being alive and having an ego. I think it’s still a question that’s being asked. What is consciousness? That’s still a very hot topic. I think the nature of these things are being answered somewhat by what we’re doing in basic neuroscience examinations. But now that we’re getting into clinical trial domains of BCIs, we’re starting to play with some of these systems in closed loop environments. And I think it’s really interesting to kind of reverse engineer the brain in real time and understand how to interface with it. That’s probably my motivation.
Juan Benet
Yeah. Were there any kind of key grand challenges that in the field that sort of got you very fired up? You just mentioned a number of really key questions, but many of those might be still kind of far away, but are there any kind of core grand challenges that either are short to midterm that you feel like we’re like now grappling with and potentially able to solve in the next 5, 10 years, 15?
Tom Oxley
Not in the next 5, 10, 15 years. I think motor BCI is seems to be the first wave. I mean, you’ve had a hearing cochlear device for hearing, I think, is a BCI. Now there’s a wave of motor decoding in order to enable movement intention control mechanisms to restore function. But the motor system has kind of been understood probably the longest, you know, since Penfield’s experiments in the 30s of, you know, Zaprain body does this, almost 100 years ago now. So the motor system is pretty well understood. It’s quite mechanical.
[3:21] Carl Jung, stroke surgery, and the road to BCI
I started in psychiatry actually and I think my early, a motivation, I was going to go down a psychiatry career. I was really interested in the biological nature of the mind and Carl Jung is probably my favorite author and I think the thing that still I am most interested in reading about is the nature of the subconscious, how that interplays with our day-to-day, what’s happening in the sleep life and then how that expresses itself through emotional content during the day. I think BCI, once we get into the frontal lobe and start interacting with some of those areas that connect back to the amygdala and have represented emotion, I think it’s a complete area of life and human interaction which is still in the dark ages. I think BCI is going to get there eventually, but I think no, it looks like motor BCI is sort of wave one.
Neuralink’s going for vision, which I think is interesting because it’s sort of going into stimulation. But from a sensing data sort of tokenization point of view, it looks like it’s going to be motor, speech, and then attention is kind of closely linked to hearing. I think there’s some really interesting things in intentional states, but then I think we get into emotional kind of emotional content decoding. And I think the the ability to I think that’s going to, yeah, I think that’s going to unlock a lot in how we communicate with one another, but also how we, I think, interact with technology.
Juan Benet
How early did you get into neuroscience?
Tom Oxley
So I did psychiatry for a couple of years. What I was experiencing clinically didn’t tie in with a clear philosophical framework that made sense. It was very social engineering, a lot of syndromes that are, you know, describe symptoms, but then whether or not you’re coping in your social life or your working life. I think now what’s happening in psychiatry with the psychedelic movement is extremely interesting and I think starting to actually get to some of those questions that I was really interested in. But I started, I tried to read Jung when I was 18. I couldn’t penetrate it. And then I think I was trying to read, you know, more core neuroscience. As soon as I went into medicine, I was trying to understand neuroscience, but it was all very scientific, core, neuronal level, structural. And so I was always more interested in the psychology piece as a sort of window into how the mind is pulled together.
Juan Benet
And when did you start thinking about the interplay with devices? Like what, at what point did that interest go from kind of understanding all of these emerging phenomena to hey, there’s a concrete set of needs here that can be addressed by, you know, a set of devices, and hey, actually the technology is not ready yet, so I’m going to have, you know, take this leap of, like, go build that in Australia?
Tom Oxley
You go straight from high school into undergrad medicine. There’s no college, there is now, but there didn’t used to be. And so I finished medical school, I went straight into working as a young physician, and I just started read, and I was then reading, getting up to speed with BCI. I first read about BCI, I think properly in like 2008, and I came across Leigh Hochberg’s paper, 2006, of the first Utah array. As it turns out, it’s been, you know, work in monkeys for decades and decades. Nicolelis, you know, a bunch of people putting in recording electrodes in brains and showing that you can decode real-time activity. So that I only started reading about that in 2008, and then my entry was opportunistic. My vantage point in 2008 was I was just doing my internal medicine training and the field of neurointervention was just starting to emerge.
[7:00] The endovascular approach: reaching the brain without surgery
Intervention is a term in medicine that means catheters, really using catheters. Interventional cardiology is putting in stents, hadn’t really made its way into the brain until kind of around 2000. You could treat aneurysms by going up and dropping a soft coil in the inside of aneurysm so you didn’t have to do open brain surgery. That was, I think, approved in 2000. And then from 2005 to 2015, physicians were starting to figure out a way to send these devices up into the brain, grab onto a blood clot, and pull out a blood clot. And that was the biggest breakthrough in stroke medicine ever. Before that, it was like using a medicine to dissolve a clot. So then it was like, “Oh no, you can put like a trap in, like an expanded, grab the clot, pull it out.” And if you do that within a few hours of the stroke, like a stroke is a blood clot that blocks oxygen to the brain. If you do that within a few hours, it’s the most incredible thing you’ll see in medicine. People coming in, can’t talk, tongue out of their mouth, unconscious, being wheeled in, go into the angio suite, 30 minutes, go up, pull out the clot, they sit up on the table like, “What happened? What are we doing here?”
Amazing. And if they hadn’t got it out, they’re either dying or they’re going to a nursing home. So, it’s this unbelievable thing. And so, that kind of, that looks like it’s working around 2008, but it hadn’t been proven. It actually, the actual hardcore randomized control trial proof didn’t come until 2015, but I was seeing that coming. And so, Rahul, my co-founder, is an interventional cardiologist. So, we were early in our training. He was obsess, intervention is very sexy in medicine. And it’s like fast-paced. It’s, it pays well. It’s very, the technology moves super quick. Because there’s a lot of innovation happening. Very rapid innovation cycles. And in heart it had exploded. Pacemakers, stents, now valve replacements, all without doing open heart surgery. And there’s a quip in medicine that, like, the brain’s always 30 years behind the heart.
So anyway, I was seeing this come through and Rahul and I would hang out a lot and we’re like, surely if those techniques come to the brain, because cardiology is kind of, it’s hitting the sort of top of the S-curve now. It’s kind of, you know, there’s probably more to come, but for the brain it’s just starting. And so the stroke thing happened, I, that’s what I came to the US to learn to do ‘cause I couldn’t train in that in Australia. Came to New York in 2015, the year that all got announced. And but I’d already been thinking, if this is true, then if what happened in cardiology happens in neuro, they’re going to solve this by not opening the skull, and this is going to be the solution.
And then during the middle of medical school, I’d done an honors degree in using transcranial magnetic stimulation in patients with schizophrenia because I was in psychiatry, but they were just doing magnetic pulses to the motor cortex, looking at patients with schizophrenia versus patients without. And we were finding these differences in the way the motor cortex activated. That was important because I got a motor cortical electrophysiology education.
And so I kind of, electrophysiology was super cool because it’s kind of the basis of consciousness, and there was a lot of electrophysiological breakthroughs over the sort of course of me going from early medicine to where we are now. So that kind of, keeping track of that, loved electrophysiology plumbing is interesting but it’s still plumbing. So I was thinking if the plumbing combined with electrophysiology and it looks like BCI is a real thing that’s clearly, that seems inevitable and world changing, what if all those things together was the ultimate solution in BCI? And that’s been the thesis for Synchron.
[10:43] Getting Synchron off the ground
Juan Benet
So you had this idea, at what point did you decide, hey, this isn’t just a good prediction about how the future is going to go, it’s rather, nobody’s doing this, we’re going to go and do it?
Tom Oxley
Well, what happened was I did my internal medicine boards. I had a year off. I went traveling and I was going to spend the last 3 months in the US and if you want to kick off, like, a new endeavor, you need funding. And I wasn’t really thinking about starting a company at that point. I was thinking like I would love, I had an ambition to be, and, you know, to be a professor, to be an academic. And so I was watching where the funding was going, and the US defense agency DARPA, this was dual use work, this is not like now, it’s kind of gone more weaponized work. So from like 2005 through 2015, hundreds of millions of dollars were deployed by DARPA and ONR global and army in a range of medical applications for neurotechnology.
Actually the history was interesting. It was like, Geoffrey Ling, by the way, was like if you, most people will point everything back, goes back to Geoffrey Ling. He was the guy, he had the idea in, he was a neurologist. He’s at, sorry, Johns Hopkins. He’s at, he was at Walter Reed. He had this vision of building a prosthetic, robotic prosthetic limb for repatriation for soldiers. Obviously if that works I go back to the field as well. That was a DARPA program called Revolutionizing Prosthetics, 2004 to 2008. Then he handed that off to Jack Judy and they said, “Well, we built a robotic arm, but now you can’t control it. So, we have to figure out how to get the control signal out of the brain, cuz otherwise what do you, how do you control the thing?” And the backdrop of that was desert warfare, Gulf warfare, IEDs, and the new emergence of post-traumatic disorder in combination with head injury. So there was this kind of defense problem of brain health which then converted into this neurotechnology infrastructure investment by the government, which then led to all these DARPA programs. I mean, a lot of the companies now have, were kicked off from that.
So anyway I targeted him and I said hey, how come no one’s, everyone’s opening up the skull? Like that doesn’t, like why are they doing that? Like if you can get in and deliver electrodes without opening the skull, that’s probably going to be the way that people are going to want to do it, if we can figure that out. And he was like, “Oh, that’s interesting. There’s, you know, yeah, if you go home and put a team together, we’ll give you the first million.” So, that was, that was kind of it, was opportunistic and product of the things that I’ve been exposed to in combination.
Juan Benet
So, you mentioned another co-founder, Nicholas. Maybe tell us a bit about them, like what sort of, like, their backgrounds. How do you compose as a team?
Tom Oxley
So, the reason this was possible in Australia, DARPA had not given a grant to an Australian group for over 10 years. It was for something in submarines 10 years ago. The reason DARPA were willing to support me in Australia was because Cochlear had originally emerged out of Australia. It was quite a couple of decades ago, but Cochlear had been very successful. There was then this kind of signal processing talent, electrical engineering signal processing talent in the University of Melbourne. And then Kevin Rudd was the Australian prime minister. I think it was 200, I’m guessing 2006, 2007. There was like a $50 million grant to create a visual prosthesis. I don’t think it worked out that well ultimately, but it generated a huge amount of academic infrastructure and there were multiple groups, lots of talent. So there was this sort of continued, this reverberation of signal processing, academic talent in the University of Melbourne and in Sydney under Anthony Burkett’s leadership.
So I got home, I started my neurology residency and then my Terry O’Brien, who was my, basically my boss, my professor of neurology, he walked me over to meet Anthony Burkett who was the guy, head of the visual program, and he introduced me to Nick, who just finished his PhD doing some, a component of hardware in the prosthetic eye. And so that plus Rahul, Rahul was my, we were very close friends, and he helped with the original concept and this financing for the original patents. And so the three of us got together and we thought let’s give this a nudge. But, you know, so the first million was a university grant, so we’re actually in our university capacity supporting that work, but I formed a company, it was sort of a shelf company, but we needed that for patents. And then I had that goal and that ambition, but really it was not for another, that was 2012, and then for the next 3 years we, you know, raised, turned 1 to 5 million to 10 million to 15 million, all in government grants, Australian government, US government, ONR global, more DARPA. We’re very lucky. And it all culminated in a Nature Biotechnology paper in 2016, and so that was, that was enough to then get the series A financing. But had a lot of trouble raising capital in Australia, moved to New York, and then started my new interventional fellowship at Mount Sinai, and then, but within 6 months we had the first financing done.
Juan Benet
That initial government funding that funded the university work, was that kind of just proving the beginnings of the technology, or like what, what the first generation of the device?
Tom Oxley
It’s a long time ago now, isn’t it? It’s still like, we’re still obviously not commercially FDA approved. You know, to this, there’s us and Neuralink who are implanting permanent devices in bodies for BCIs, and that’s after a long, long time, a lot amount of capital. That’s how hard it is to get to the point where you’ve got a device that is safe and effective for what it’s meant to do, and we’re still not there. So, what were we doing back then? We were trying to prove, like, we were trying to solve a very mechanical, electromechanical problem of how do you attach and push electrodes that have insulation, that are like electrically, you know, isolated. Cuz you know, the lovely thing about going through the bone is that you can put your package right there and you have your feed throughs right there. And so all of your electronics can be done where it’s hermetically encapsulated at the point. And so you don’t have to solve this challenge of connections. That’s been the huge challenge for Synchron. That’s been the huge limiter on, on our, the ceiling and limitation of the technology through our catheters has primarily been how do you handle the noise of having a very long cable coming down? How do you, and then how do you achieve good insulation, and how do you get more channels in, and in the end the limiter was around how many individual cables you can put into one device that can be left inside a blood vessel.
Juan Benet
Let’s go into exploring the device. Just maybe redescribe the device, giving people maybe a view into Stentrode in general.
[17:24] Reading the brain: channels, signal, and noise
Tom Oxley
I guess the idea with the BCI is, you know, if on this podcast you know probably, but just briefly, you have to detect electrical activity close to the source of signal generation that’s associated with some signal that’s valuable, and in this case it’s the motor signal, the intention or volition of motor signal. It’s because it’s internally generated. You’re in control of it. You can therefore control an external signal if you can capture, decode, and bring that signal out. So, how do you deliver a sensor with enough fidelity close enough to the motor cortex that can be used to drive an external device? So our technology is what blood vessel is closest to the motor cortex, and what’s the first blood vessel that you would target and is big enough and is safe enough and has that, people have put in things before, and where’s the best place to put it. And so we used a traditional stent architecture, cuz a stent is a metal scaffold that expands. It pushes against the wall and then we figured out how to put multiple sensors on that stent. So we have 12 sensors on the device that’s currently in front of the FDA. And knowing, and so you know we made a bunch of design decisions that we knew would be manufacturable at scale, cheap, cuz it’s very expensive, these systems. And then the question is and remains, like what is the minimum use case that is needed to drive control of a system that’s actually useful for people, because if you overshoot with redundancy, you’re really paying for it. You’ve got, if you’re not using all of your channels, or if you’re designing for an abundance of channels.
Cuz Neuralink came in with a very ambitious, you know, target, and we kind of came in from the bottom end saying, well, you know, what would be the minimum needed for a first-gen system to let us move more quickly, because we’ve got some future generation systems that we are very excited about, but we kind of wanted to first explore what does redundancy look like and what’s the minimum use case. And so maybe the short answer to that is now, like, the relationship with Apple has been critical, because we’ve kind of identified a discrete low number of, like, I’d call them gestures or kind of control, you know, embodiment thoughts, that would be enough to allow someone to navigate their way around a useful system such as Mac OS or iOS. And so that’s, yeah, so that’s where we’ve started.
Juan Benet
Yeah. And that can, like, massively broaden people’s interaction with the whole world, because if you can actuate a computer, you can then start controlling all kinds of other systems and you can communicate with a lot of people. What are the lives of patients that need this, like before and after this kind of device?
Tom Oxley
There’s been an interesting dialogue in the field about who could benefit from this, and as we’re moving through uncharted territory, the definition for the FDA and for Medicare, who are going to pay for the device, really matters, and the use case really matters. And so we’ve kind of, it’s been a bit surprising hearing from people that I might not have thought would have had benefit, but I kind of categorize it as, if you lose control of your ability to control your device, you normally use your hand or your mouth. There are other accessibility features that use eyes and maybe head control. Some people have a sip and puff, but there’s actually a range of conditions where people lose the ability to normally control their system. And then there’s a range of different accessibility products out there that are not standardized. And working with the Apple team, particularly the accessibility team, has been pretty incredible. Like the different use cases, the power, like the different mechanisms that they have are very broad. But I think that what’s exciting about BCI is that you try and standardize everything towards a single, because you go back to the, so it’s not like oh I have a little bit of finger, I’ve got a little bit of movement in my cheek, or I’ve got my eyes are okay but they do this sometimes, my voice is getting soft but sometimes it works. So everything else is very bespoke, but if you go back to the source of the motor signals and the brain is still okay. And so for a lot of people the motor cortex is viable, is like alive, but you’ve had a subcortical stroke, you’ve had a brain stem stroke, you’ve got deination MS, you’ve got cerebral palsy, you’ve got movement disorders, you’ve got Parkinson’s disease, you’ve got ALS, neurodegeneration, you’ve got a spinal cord injury, you’ve got a nerve injury, you’ve got a muscle injury, you’ve got joint problems, and then you’ve got muscle disease. So there’s actually, it’s been incredible to hear from the community with the level of enthusiasm around the idea that there would be a implant that you can get that gives you back control of your Apple device. We take it for granted, and there’s been a lot of somewhat tech negativity recently, and there’s certainly BCI’s struck with the dystopic stick.
Yeah, but when you speak to people, and I can only imagine what it’s like to have lost your autonomy, then that’s what this technology is about: restoration of independence and autonomy using devices.
Juan Benet
Yeah. And in the core, personal computing devices are the launching point to many other kinds of things. I can imagine people might even be able to like run programs that then enable them to move around or like control a chair or maybe have some like basic locomotion or things like that, all mediated by, you know, their personal computing devices. But what sort of stage is the device in now? Like you’ve had a range of trials already. Give us a sense of what you’ve proved so far. What’s next?
Tom Oxley
I’ve been watching with interest the Meta’s neural band, and that’s been a long journey to get to that. A lot of similarities to actually ice. So they’re doing gesture classification with the neural band using an EMG band and they’ve got like a handful of gestures that can be used, and they’re trying to achieve zero shot classification which is very low burdensome, low training required, a lot of training. So what had to happen there was a huge data set, good experiments, and then it was the development of ML pipelines that could be used to achieve this goal of zero shot gesture classification, very similar to what we’re trying to do in the brain. So to get to that point, you have to have hardware design freeze. Then you have to have data collection. And so the big challenge with BCI is that you can’t train until you have someone with the implant doing training. So it’s been a huge impediment to progress, fast progress in the field. But I think what that means is that when scale starts to happen, there’s going to be a takeoff that’s going to be super interesting in this field. So it’s going to be going slow, slow, and then it’s going to go wow, and then with scale is going to come better procedures, better ML pipelines, better features.
So, we’re now at the point where we’ve done two clinical trials. We’ve learned a lot. We think we’ve figured out what is the base level of gestures that can interface with Apple’s accessibility platform. We’ve got a new Bluetooth HID protocol, which enables back and forth computer to brain, which is awesome. And we’ve hit a design freeze now, and we’re now going to scale up for more implants over the course of the next 12 to 18 months, with the goal of getting to a pivotal trial and then commercial approval. So the way we’re thinking about this is we’ve got a target in the brain. We’re trying to reduce the dimensionality as much as possible. Target in the brain, area of the motor cortex, we know, same blood vessel, same size, gestures we want to achieve, the use case we want to achieve, show that it helps people be independent. I feel like it’s been a long time. We’re now getting very focused on what we think success will look like in the clinical trial. So there’ll be this period, FDA said they want 30 to 50 patients in a pivotal study. Then you’d submit the pivotal study to the FDA and you’d get commercial approval, and then you can start selling, which by the way you need Medicare to cover the payments for, because most 90% of people who have severe motor impairment or paralysis are on Medicare. So that’s another element which I think the field is maybe undercooking a little bit. That’s all ahead of us in the next sort of 3 to 5 years, and then all going well, then I think there’s going to be a big ramp up towards large numbers of users. And so I have a vision where there’ll be a software system, there’ll be a training apparatus, there’ll be a number of use cases, and then there’ll be a constant release of new features or gestures, and we’ll be building out an app where there’ll be a certain interaction methods on offer to engage with, but ideally what our goal is to enable our users to jump out of the app and use the natural ecosystem of Apple’s iOS, and then we’ll move on to other platforms. But we’re enjoying working with Apple’s platform a lot. With my open source hat on, would be great to develop very good portable interfaces there so that any kind of device can be plugged in. And yeah, so Meta has released all of their neural band data and there have been other groups, like Apple has been, you know, working to try to do better zero shot classification. So I think that’s, I think in BCI as well.
Juan Benet
I imagine it does raise, it raises a bunch of questions though about, you know, who owns the data, how do you release it, you know, what consent did you get to do that, who benefits?
Tom Oxley
I guess with Meta, they’ve handled their privacy issues with the neural band really well, but they’ve found that line of like doing on-device inference but also releasing data for aggregation for improved, so you know, that’s actually a good model I think for the field. The current device is read only.
Juan Benet
It’s read only?
Tom Oxley
Yeah. Yeah.
Juan Benet
And will you be able to do write in the future?
Tom Oxley
We have a plan to do stim. The challenge with stim is that it takes up about twice the amount of space on your PCB and a lot of energy. So, as everyone’s trying to get smaller and smaller and further and further, I think the question that we’ve been grappling with is cuz Neuralink’s gone in for stimulation and vision, which is an interesting move, but I think there’s, I think it’s all a trade-off, and especially for us, like, with our next-gen system, space is at a premium because we’re trying to push chips through catheters now, which no one’s done before on the scale factor that we need. So I would say that I think stim, I think write is somewhat important. I think if you’re going for vision it’s extremely important. I think for most other areas in the brain it’s less important. For motor, haptic feedback really matters, but you don’t need a huge amount of discrimination for haptic feedback. And you can send bits in, for speech it can like tell you about speech interruption. For hearing it can be interesting because you can, you know, provide prompts or just feedback. But I don’t know, like the brain has got very good to write, like we’ve got very good ears and very good eyes generally. I think the bigger challenge has been the output. So I still think there’s going to be more value generated from sensing and reading at scale, and because once you sense and you read then you create, you identify features, and then you tokenize, and then you’re building layers that can interact.
Juan Benet
With the current generation of device, how much can you read out? Is it sort of a number of different neurons around the blood vessel that you’re able to tap? What’s the scale there? Like what’s the kind of equivalent to where other BCIs might be talking about, I don’t know, number of channels and things like that. How do you think about the IO?
Tom Oxley
We’re actually in a class of our own from that perspective. I think everyone, it seems, jumped straight into the super high channel count world. I think because Neuralink did that, EEG scalp based EEG at times can do things. So, I thought there was a pretty interesting medium between doing a lower channel count starting point. As long as you can serve a use case, it’s going to be a lot cheaper and more scalable, and I think probably safer than others. So, we’re in a kind of category of our own with this first-gen system. It’s going to have 12 channels. It samples at 2,000 Hz, and so we’re, you know, we’re recording up to like 500 Hz activity. So, it’s like intracranial ECoG. The sensors are laced within the blood vessel around the precentral gyrus in the left and the right so it can detect, and we’re also we’re seeing a little bit of stuff from preoter supplementary motor, but primarily primary motor cortex, and we believe that’s enough to generate a handful of gestures that enable a level of device control. And then for our next-gen system, we’ve got some extremely exciting breakthroughs that we think are going to enable super high channel counts in distributed regions. And so one thing I’d say, I think for the field to keep growing I do think there’s going to be a Moore’s-law-esque thing, but to do that you have to find a way to scale up the number of sensors, but it’s not necessarily about the density. I have a belief that spatial coverage really matters. Because the brain has its own redundancy built in. And so what I think is that there is a sweet spot for coverage, because you need unique information. You need unique information from different brain regions, and you don’t want to over sample. So then if that’s the case, if you hold that thesis, then the question is what is going to be the best mechanism to get in there, navigate around, deliver packages, and then get out without destroying local anatomy. And I think that’s going to be one of the challenges that skull-based approaches are going to face as they want to get to more and more regions of brain. What do you do there? How do you, so you know, but there might be ways, there might be ways to achieve that. So I think the vision here is that we’ve got this first-gen system that we’re kind of solidifying a use case. We’re going to build these ML pipelines. We’re going to build a system that controls Apple products. And then our next-gen system, we are have to solve the issue of tiny chips across a distributed range where you can navigate around and not be limited by space. And we think we’ve got a pretty exciting solution for that.
Juan Benet
With that jump in regions and channels, what are some of the applications that you’re thinking about being enabled?
Tom Oxley
Yeah. So, so motor, a motor system is about predicting the intentional activity from the motor system. If you go to speech, it’s the same thing. Actually, the speech decoding right now is kind of also just doing motor decoding of the creation of speech. There probably is then speech, semantic speech decoding. So then you may be getting into concepts or ideas as you’re moving into the frontal lobe. But then you if you’re into the frontal lobe, then you’re getting to emotional content. All the non-verbal things that you communicate are kind of taken for granted a little bit. You know, it’s the little gestures, the little the eye, the facial expression, the tension, the triggers, the annoyance, the frustration. If that can be decoded, I think that could be really transformative. And I and people might say, “Well, [ __ ] I don’t want to be I don’t want to have my emotions.” And I get that presuming that you can find a way to solve privacy. It feels to me like it would be a mirror because you go to therapy to basically get told that, well, you reacted in this situation. You know, you should think about maybe it was because of this. But if you had a system that in real time could feed you back like what is going on with you, that could be a hugely beneficial thing.
Juan Benet
Presumably, you could also detect all kinds of early signals of potential problems or emotional disorders and things like that.
Tom Oxley
Yes, there’s probably some long-term health benefit, but I think the value of BCI is primarily going to be in the live kind of contextual utility. Imagine that you had a system that started to build knowledge of your typical behaviors of react. Now, it has to have context to the environment, which is is kind of an obvious statement, but the BCI will eventually train on making predictions on how you would likely react in a certain environment. That would be, I think, an emotional. Well, actually, that would extend to like things like navigation as well. I think there’s a big portion of your brain that’s there for navigation. So, I’m sure there’s going to be some navigation input that means you don’t have to check your phone for stuff. But I really believe the emotional sort of subconscious piece. I guess it’s like there’s the mirror piece. There’s the for people like I have a lot of people with families with people with autism who write to me saying if you could help like transmit the internal state of my child or my brother we could much better understand what’s going on because we have a, because the use of language with people with autism is very challenging. So we get a lot, we get a lot of people. So like that ability to oh like actually his emotional state is this right now, I thought he was angry, or, you know, so I think there’ll be conditions where there’s kind of a decoding element to it, but then I also think, like, you know, I keep thinking like as robots become, physical AI becomes ubiquitous in our world, you kind of want it to know how you’re feeling. In the future, I think this technology will, if you choose to let it, you’ll have mechanisms to express yourself in a way which the world around you will be able to react to. I’m also a little bit scared of that myself. Like from an ethics perspective, I think there’s huge challenges in getting that right. But if we did that right, I think it’s going to help us overcome one of the biggest challenges of being human, which is that we all piss off each other so much. So bad at like communicating emotionally with one another and with ourselves and like being aware of yourself.
And one other thing I was going to say, it seems to be the case that we’re learning that doom scrolling, like TikTok, is having an impact on young children, but it’s also having an impact on everyone because it’s very addictive. And so there are these patterns of mental behavior that are very bad for you that you will do. I think the technology could actually be helpful in identifying when and how you’re using your brain in a bad way and actually just be a bit honest about it and help you manage it better.
Juan Benet
Yeah, in that good, once you have some amount of read write figured out you can also help implement better self-regulation pathways and all that kind of thing. There’s a range of people that are very excited about even things like being able to regulate sleep and, like, just kind of induce sleep through a BCI and things like that. Would you be able to do speech with the next-gen device, or like, further on?
Tom Oxley
Yeah, our next-gen system is going to be able to reach all corners of the brain and deliver high channel count systems. So yes, we’ve, the question is where do we, and what do we do with it?
Juan Benet
Very exciting. Super cool.
Tom Oxley
We’re very excited. We’re going to, we’ll, we’ll probably be making some announcements about it in later 2026. It’s been like 12 years of thinking on this problem, but there’s, I’d say that there are some techniques that have been used in cardiac which are not obvious which will let us get to regions that were not thought possible before.
[36:41] The numbers: 15M patients, FDA, and Medicare
So, in all the conditions that you mentioned already, just even with the current generation device, there’s likely millions of people globally. I mentioned a bunch of conditions from a motor perspective. We think there’s 15 million people global that have either moderate or severe motor impairment. From the range of conditions I said before, on the very severe end of the spectrum in the US, we think that’s about 3 million, and then we think there’s about 700,000 people on the severe end of the spectrum in the US. This has been an active conversation in the field right now. We were talking about it at your retreat, and we’re hearing that Neuralink wants to implant people that do not have injury or disease. My view is that that’s all a little bit rushed and it’s going to take a bit of time to show that it’s safe and effective, and I think we’re going to be in the domain of motor systems primarily, and I would include speech in that, like motor speech, as the first wave for the next, say, 10 years, 10 to 15 years. I think that’s vision with prima from science with vision as well. Yeah. Yeah. I’m kind of putting vision in a different category cuz we’ve talked about this cognitive AI thesis.
I think to build a framework like that can predict the next kind of cognitive token, that’s more of a sensing thing. The feed, the write, is interesting, but I don’t think it’s as interesting as the architecture of a sensing system that can help predict the next cognitive action. So then, you know, we talked about motor and speech and emotion and maybe attention. I think attention is a super interesting thing because if you can start to cover, so there’s been a lot of discussion of whole-brain BCI. So you know, what is whole brain? Well there’s a lot, the brain does a lot. So if you can cover multiple different cognitive domains including those ones, you can build models that can kind of create predicted features of the user given a certain context, and you feed that into the model, it starts to begin to potentially supplement your cognition in any moment. So then it’s like, okay, who is going to want that? And I don’t think it’s just going to be a jump to like normal people. I think this is going to take, you know, 10, 20, 30, 40, 50 years. And what I’ve been thinking about is the next wave after, say, motor impairment. I’ll include speech in that because speech impairment is a subset of a smaller subset of motor impairment. I was thinking there are people with age related cognitive decline and maybe mild cognitive impairment, and then you’re getting into the hundreds of millions of people. Some people have more cognitive decline than others, but there is a very common phenomenon of people getting into their 40s, 50s, 60s starting to report cognitive slowdown, some moving into mild cognitive impairment. If these systems can supplement your cognitive processes, help you engage in elements of communication that includes emotion, or with technology, and it can kind of fill the gaps that start to happen, it can sustain you at a cognitive level. I think that is the sort of thing that a large population might start to adopt because it’s, you’re not, it’s not a like a, it’s not a utopic BCI superhuman vision. It’s more like how can we preserve a level of cognition over a longer period of time. Now, I’m not, I’m not saying that it presumably goes to a level that is superhuman in some way, and maybe there’s a becomes a market for that. But there’s also a lot of push back on that. There’s a lot of questions over how, what happens to society when you start to do that, and who are the people doing that.
Juan Benet
And so, but couldn’t this, just to push back a bit, Steve Jobs used to say the personal computer is the bicycle for the mind, and I’ve been thinking of the BCI as the car for the mind, where it’s like a much harder to make device, much more complex, much more difficult, more broadly impact society and reshape society, but as soon as you sort of like get it working at scale, the benefits globally just become so dramatic that that kind of becomes like a key thing for lots of people to have. And so what’s the scale of utility that a device like this can give such that yeah like people broadly say hey like this would be a way of interacting with each other with the world with AI with all these systems that’s just kind of a, you know, broad capability expansion, and kind of like how far away that is. But I would imagine as soon as there’s thousands of people out there already, maybe tens of thousands, maybe even more that would want to have that kind of mind expansion sort of human experience broadener.
Tom Oxley
I’ve thought about that. I’ve the car analogy I think is interesting. It’s a little bit dangerous. It helps you get there faster. It’s like it, when the car first appeared it was, people were terrified. It was like a horseless carriage.
Juan Benet
Yes.
Tom Oxley
And there was, and there were moral questions about it. There are no more moral questions about cars. So, I’ve reflected on that. Although, I think the ethical questions because it’s your mind and there’s now skepticism around how technology is used from a privacy perspective. I think there’s potential much more push back on this technology than, and maybe adoption, and even like discrimination in how it’s going to be rolled out, time scale. I don’t know. It takes 10 to 15 years to go from inception to commercial approval in the current state. Maybe China is going to do it quicker than the US, which is a very high likelihood. And so we’re still in the domain of like motor systems right now. And you know, Neuralink’s not covering much territory unless they’re going to go and start putting holes everywhere and putting multiple in. That seems really difficult. Tons of holes over the skull. Like it seems like a not super scalable. Yeah, I think Elon wants to remove the whole skull and just put a helmet, but I don’t think that’s going to scale into the population. And I think that, you know, so I think we’ll probably have digital humans uploaded before we probably have large volumes of people replacing their entire skull. Yeah. The problem is to you need context. I think to train these systems, you can’t just do like a go into an imaging, go into an MRI and just get a scan done. It needs to track your brain. You need to train it against how it’s reacting in real time, kind of like a car. So I still think it’s going to take time. And so to build these systems that are going to have such great digital twin capabilities, you have to have coverage in many different regions over a period of time where it’s being trained over a period of time. It’s a major design challenge because you don’t actually like once you’ve trained it, you don’t need all that compute. But the problem is you have to build it all in in order to achieve the training, but then you can run it on a much lower order of power and compute. But you have to get there.
[43:18] Cognitive AI: foundation models, the data economy, and the 2040s
Juan Benet
So, yeah, let’s go into the cognitive AI thing. So you already touched on this a bit but kind of the broad idea is hey, across a range of patients you can collect a range of neural data and start building foundation models that enable you to have, like, the zero shot learning for additional applications and so on that require very little individual training to be able to use the device. So, so you can kind of onboard faster, but there’s probably also, you know, a range of applications that become unlocked also in terms of integrating data from multiple devices potentially and being able to get better models of how the brain works and how various signals work. Yeah. How have you thought about this and kind of what is sort of like a timeline? How much data do you think we’ll need? What are some of the early fruits that we might see?
Tom Oxley
Yeah. And then and then the third part to that list was then potentially these models being useful when taken out of the loop and then using to, you know, so if these models get so good that we’re learning things about how the brain works that we hadn’t otherwise learned, then they can potentially inform out of the loop models to control physical AI. I think it’s going to take time. So Nvidia is, so Jensen’s very interested in this, and Nvidia are kind of watching the space wondering, this is a new data economy emerging, and they wanted to sort of step in when compute will accelerate the progress within BCI, but you come back to that challenge of you need the data and you need a lot of data from many people, and so this is the, this is the arm wrestle, it’s going to take, that’s why I think it’s going to take a bit of a bit of time. You need distributed systems, you need them live, you need contextual features, and then you need some interaction with the system that enables some model to train and learn, and it needs to be delivering useful features all the time to the users. I think it’s going to take time. I think, you know, we’re in the first innings. We’re seeing first generation, I’d say our systems, first generation system. You’re seeing second generation systems starting to emerge. I think third generation systems, I’d consider our next thing coming, a third generation system is getting into the whole brain domain, and then maybe fourth generation systems are beginning to, you know, be safe enough, scalable enough, easy enough to use and useful enough to start generating that level of scale of data. In terms of neurotech right now, the most voluminous neurotech implants in the world are the cochlear implant, and they’re doing about 40,000 units per year. They’re pretty low numbers, like cardiac are doing a million stents, a million pacemakers. So, neuro still got some, this, this, you know, everyone’s approaching this slightly differently, but we’ve still got a way to go before we can scale. Even the infrastructure, the way the hospital systems are set up, the number of neurosurgeons, the neuro-interventionists, the places you can get things done, people don’t want to have to travel a huge amount to, so there’s still a lot of maturing to happen. That’s why I think like we’re looking at like 2040s, 2050s for some kind of an event horizon where, you know, there’s some, I don’t know, I don’t want to call it singularity, but that there’s, you know, a moment where the system starts to surpass what the human body is capable of doing.
Juan Benet
And I think you were kind of getting at it from a network effect, but I do think there’s going to be a moment where there’s enough people that can start to interact with one another in a way which is not capable using the normal human body. And again, back to emotions, the most obvious example of that is I can somehow broadcast or throw my emotional state so I don’t have to explain to you what’s going on. And so when you get to that level of, and that’s very human by the way, that’s a very intimate human engagement. So I think there could be the potential for these systems to enable a level of human interaction that is maybe incredible, like feel amazing and like very intimate. The Nexus sci-fi book has a whole, it’s a BCI oriented story, but it has a great description of the just like the human experience of being able to sense each other’s various emotional states and being able to tap into like this kind of like shared reality that just isn’t possible otherwise once you have kind of very high bandwidth connectivity between human brains.
When Android’s Dream of Electric Sheep, the, that was a book that Blade Runner was based on. I think in the first chapter they dial up each other’s, that’s a bit more dystopic cuz that’s not like the husband and wife are fighting and they dial up each other’s mood for the day.
Tom Oxley
Yeah. There’s this kind of bad effect where in order to kind of sell a story well, you just need elements of high drama. And usually when some technology isn’t clearly serving a purpose to the story, it tends to get cut. So you have this selection pressure for stories to become overly dramatic around technology. So, so you just select for sci-fi to have dystopic lenses over the possible future. And so you end up with this distribution where most of the sci-fi that you read feels dystopic, and so we have like a dearth of extremely positive visions of the future spelled out in sci-fi.
Juan Benet
That’s interesting.
Tom Oxley
But there is like some archetypal dystopic narrative that is like I think ingrained genetically in the human brain. We see a handful of quite idiosyncratic like predictable psychotic delusions that occur with people who have psychosis. And one of them is that you have put something in my brain or you’re taking things out of my brain.
Juan Benet
Fascinating.
Tom Oxley
So I’ll get an email once a week about someone who thinks I’ve put something in their brain. What I think everyone, all the companies are getting this. So that’s why, that’s why there’s no signage on the building.
Juan Benet
Wow.
Tom Oxley
Death threats, like, a lot, so there is this kind of cultural embedded fear around like stealing stuff from my brain or putting things in my brain that I think fuels it as well, but there’s cultural obsession with BCI.
Juan Benet
That’s the first time I heard of that. I can imagine it’s similar to like 5G chips conspiracy theories and so on.
Tom Oxley
Probably, and we’ve got Bill Gates as an investor, so that was a double, that was a double whammy.
Juan Benet
Yeah, maybe going into AI and neurotech, how it might co-develop.
Tom Oxley
Certainly, a lot of AI has already helped BCI tremendously by being able to decode signals much better and solve a lot of the hard challenges that we were, we thought we were going to have around how do you even extract signal from the brain and so on.
Juan Benet
But what are some of the other ways that you see kind of AI accelerating BCI development now?
Tom Oxley
I was at an Apple event and there was lots of conversation around like the word, the term foundation model was, is being used a lot now, and so these foundation models that enable this zero shot classification I think the idea that you’ve got a mechanism to train models that are increasing in size that can improve your ability to separate signal from noise in a way that you probably couldn’t have done with a supervised method, seems to be a huge driver of space. So the ability to use large compute with unlabeled data with self-supervised techniques I think is going to drive, because you know we see signal and it looks like there’s noise but it’s not actually noise. It’s all different signals coming from the brain and you don’t know how to parse it all out. So I think the ability to use high amounts of compute to solve that is going to be a really big deal again, which means more data is going to have better features. That’s on the ML side of the decoding. But I think the other interesting side is if the BCI enables interactions with your device, like OpenAI is building a new device now, right? So is is typing in on a keyboard into a prompt to activate the next thing, is that going to be the best way, especially as the AI, so I think the interaction between the BCI and prompts is what’s going to be super interesting, especially when if the BCI is predicting your next cognitive move and that can feed in in real time to a prompt and you can have real-time interactions, then you might have very fluid and really quick interactions with the AI in a way that didn’t require you to sort of sit down and use your hands on a typical interface with a keyboard or a mouse.
Juan Benet
At what point do the blending of these systems start feeling like an extension of you, as opposed to like a separate device?
Tom Oxley
That’s already happening. That’s already happening. I’ve seen some examples. If you want to speak really quickly in a conversation, then you might skip the keyboard altogether and just choose what is being generated as rapid prompts in real time, even if they’re a bit goofy or not quite right, the user will much prefer to do that because they want to be live in the conversation. And so even if you can because like we’re talking, I don’t know, 120 words per minute or something. So even if you’re typing on a keyboard at like 60 words per minute, even 30 words, 60 words per minute, you’re still not actually keeping up in the conversation. So there’s a huge driver of people who have disability or impairment to be live and active in a conversation and they would prefer to say well I’m not, I’m not speaking for everyone here. I’m speaking for some people that I’ve spoken to. They’ve said I would much prefer to say something even if it’s a little bit goofy and to impart an effect on the conversation and have people react to that and then redirect and keep going. Then you’re like well was that really what you wanted to say? Like was that exactly, I don’t know. For me, I’m always struggling to find the exact words in my brain anyway, but I’m not diminishing that. There is definitely an agency. Nita Farahany feels very strongly about this. I don’t know if you’re talking to her, but she wrote the battle for the brain and she talks a lot about cognitive liberty. She’s very worried about what it might mean to have the AI, the combination of the BCI predicting your next move and the AI predicting, and then your agency having a couple of steps removed, and then what that will do to impact you and yourself.
[52:56] Consciousness, psychedelics, and the extended self
Juan Benet
Yeah. And there’s hard questions here around, you know, how many layers of brain are involved in that anyway, and at what point does the tool and machine that you’re building just become an additional layer to the brain as opposed to a separate system. You know certainly like the human neocortex is a totally different system than like, you know, the much earlier, you know, the cerebellum or like, you know, the brain stem and so on. And somehow our brain is able to integrate these systems and experiences to form a coherent whole, probably as a result of the degree of connectivity bandwidth like this. I’m reminded of the corpus callosum experiments where they can find different personalities in the different lobes of the brain. And so that’s a sign like when you don’t have that kind of degree of connectivity, then your shared consciousness is potentially split into like separate components.
Tom Oxley
Mhm. But that suggests that if you have a high degree of connectivity between your brain and some other system, you may be able to cohere that into a single system or a single kind of conscious experience. I don’t think we know enough about consciousness yet to be able to tell whether or not that will happen, but we’re probably going to experimentally reach this sometime in the next decades.
Juan Benet
Have you seen these explanations of how desynchronization, especially the default mode network, which is kind of thought to be this sort of resting state network that enables your consciousness to exist, the high-dose psychedelic drugs, mushrooms, DMT, acid, cause a desynchronization, the resting mode goes away, and they, I’ve seen some descriptions on MRI studies of a desynchronization event where you lose that resting state and then you actually go offline and go to some spiritual place. So there’s, there’s lots of us, there’s still a lot to learn.
Tom Oxley
That reminds me of studies around certain types of meditation that reach like probably very different behaviors but it’s the meditation effect is also a desynchronization event, the same as the psychedelic. It’s the same, seems to be the same process of desynchronization across the brain and high connectivity, but it somehow that results in a loss of ego and then going to some other realm.
Juan Benet
Yeah. Yeah. Yeah. Once you start kind of interfacing with all of these systems with AI or other people or other humans in high bandwidth, like that that just kind of starts opening up a whole range of questions about, I don’t know, the future of humanity and like the species and how we develop, like how much do you either think about that, or are excited about it, or?
Tom Oxley
I think about it a lot. I’d say I’m cautiously optimistic but I’m a little bit worried. I’m worried in particular for the things that we don’t handle very well as humans, which is the addictive component of the technology. So the idea that a BCI would enable interactions with a system that is puts you into that kind of passive scrolling mode and reduces your agency, I think that’s a major problem. I think it’s probably going to be about the user and the product, but we’re learning with social media that there is this very addictive element to the way that we use these systems. I think we’re already seeing that now though with chat basically. People are kind of offloading cognitive work. You’re now receiving work from people where you think it’s their work and you can tell it’s like, but it’s okay, like you’re like, okay, I know that you’ve used chit to generate this, but I can still, you still generate the themes and it’s a different slant, but you have to sort of think about it slightly differently. So we’re definitely going in that direction. I’ve definitely already encountered cases of that. There was a whole conversation with multiple people, all of which was ChatGPT talking to itself for all parties.
So, individualism is still a bedrock of Western society that I think we have to uphold, and I think BCIs could go in either direction. I think they could be profoundly individualized or they could result in, you know, more group think or group connectedness.
Juan Benet
Yeah.
Tom Oxley
There’s geopolitical differences emerging. China’s got a very different approach to this, probably, to Western societies, and they’re probably going to be deployed in very different ways. So I worry about privacy. At the same time, I think that there are elements of, like, using the system to preserve your, like, not privacy but maybe something like sovereignty, you know, like your agency. Yeah. Your agency. Like ironically I think you can use these systems to determine whether you are actually behaving with agency or not. So that’s kind of ironic because I think it could go in the other direction, but at the same time I think they could be used in a really good way to have an honest conversation with, you know, how human are you being right now.
I mentioned discrimination, how society’s going to handle pluralism. I saw Steve Bannon comment about a very vicious anti-Elon rant that he had about the potential of BCI like he was talking about Neuralink resulting in major cultural divisions because, you know, there’s going to be like, you know, anti-BCI people or like, so, or they’ll, you know, discrimination, either you couldn’t get one cuz you couldn’t afford it, so like equity problem, but also discrimination in that people begin to like detest or, you know, feel hatred towards people who might have these technologies. But the other side of it, the positive side of it is, like, self-determination, like more agency, more autonomy, more decision making, more protection of yourself, like more extended human behavior, that you could, like you were describing the car, I think I do think about that analogy. More capabilities, more capabilities, more forms of expression, more forms of experience. Yeah, I do think that it could open up parallel streams of cognition, which we kind of do a little bit. You like you multitask and you think about different things at once. But actually, but usually when you’re doing one task, there’s one kind of dominating thing. But if the device is running, if the brain is running in parallel, you always got a thought in the back of your head or something you’re worrying about or you’re distracted, you know, are you listening to me right now? I do think the BCI could potentially enable multiple, like if agents come online, physical AI, it’s now using your cognitive tokens to predict next actions in some AI integration. It’s start, and you’ve given it permission. It’s starting to act on your behalf. Oh, you’re worried about where the car is. I went and made a phone call. They’ve topped up your parking meter. I spoke to the police already. You know, it’s doing five or six things at once and taking care of stuff for you. I think that could be amazing. But then it’s like, well, were we built for that? How’s the how are we going to handle that? Like,
Juan Benet
Yeah. And if we can figure out the, how do we input that information back? So, it’s not another thing doing it on your behalf, but it’s rather it becomes kind of like an extension of you, and you have some degree of awareness of what’s going on and control over it, and so on.
Tom Oxley
Nita Farahany talks about, what does she call it, when the fiduciary, the same way that you treat your physician or your lawyer, you need that level of trust in it.
Juan Benet
Yeah, totally agree that if it’s a separate thing that’s acting on your behalf, you definitely need that level of trust. But I’m also thinking of a case where it just doesn’t feel like a different thing anymore. It just becomes part of you. If you can increase the connectivity between that process and yourself, then kind of, you can kind of, we can potentially integrate it. To your point around, are we ready for that, or are we built for that?
Tom Oxley
I don’t know. We’re not built for, we’re in the middle of a concrete city with like skyscrapers and so on. We definitely didn’t evolve for this. Like we were, you know, our genetic evolutionary path can’t adapt fast enough to the technology that we’ve been building. And so early hominids were never meant to like, I don’t know, build steam ships and go around the planet.
Juan Benet
Yeah.
Tom Oxley
I think as with any tool that is very powerful, it can go in different directions. The thing I worry mostly about, those elements of humanity that already, we’re already seeing causing suffering in this. But there’s also a dialogue in BCI that it’s going to be some solution for AI alignment and safety with AI. I don’t think that’s the case. Like it doesn’t make sense to me that like it’s going to definitely expand human potential, but along the trajectory of ASI, it’s not, it’s you’re still interfacing with the biological.
Juan Benet
Yeah, maybe back that, and for listeners, so try to steel man the argument that you’re, you’re the steel man would be, evolution of humanity is slowed down on the scale relative to what technology we’ve created, the potential, and so evolution was powerful and we like keep improving, but the pace is so slow we need to find a way to evolve humanity so that we can keep up with AI. And if we do that, we might be able to interact in a more safe way and continue to steer AI in a safe direction so that we never lose control of the AI and we don’t become its slave.
Tom Oxley
Yeah. Right now, we’re on a path to potentially create a separate species, that will be first generally intelligent, and kind of superhuman in some jagged sense, but then later superhuman in maybe all counts, and then eventually like ASI. And if we build it as a separate thing, then we have this hard question around which species is in control, which is like a very uncomfortable question. And so the part of the steel man argument is maybe there’s a path by which if we can figure out connectivity between the human brain and the AI systems, then as they develop, we don’t build them as a separate thing, but we build them as part of humanity.
[1:02:54] Agency, addiction, and geopolitics
Maybe just a quick divergent going back to the things that I worry about is that the end destination with everyone getting a BCI is that we do all become connected in some way and then there’s some loss of individual agency from in that process. There might be cases where you have such high connectivity that you do, or there might be cases where you might still be able to preserve individuality in that environment. I really hope so cuz I think that’s like a key thing about being human. That was Jung’s kind of apex, and Nietzsche actually like finding the apex of individualization, was actually how the entire species moves forward because we’re all strive towards our own very unique experience and those highly differentiated unique experiences are what, where we learn things a little bit different, and that’s how, like, the edge case that helps us learn. So, I worry about losing that.
But with the ASI thing, like I like it. I like the idea that okay, it’s like we’re somehow more connected to it, but that doesn’t mean that there’s not a separate ASI being that we’ve created. Maybe we’re a little bit touching it a bit more. But the idea that the ASI’s trajectory relative to the human brain trajectory, which is interacting still with a static kind of biological lump, doesn’t, it doesn’t make sense to me. Even if we manage to interweave AI systems and the human brain and interface them to some degree, the interface boundary still like quite different, and so these might not fully integrate, and even if we do, it’s likely that separate from all of that, you might still be generating an ASI in a data center that is not connected to humans, and so that whole process might be just fully unavoidable.
Juan Benet
Yeah. Or you’ve actually made it worse by connecting to it because we’re a species that’s less powerful and now connected.
Tom Oxley
Yeah.
Juan Benet
And then maybe exposing some degree of like attack surface in a sense.
Tom Oxley
Exactly. Which you’d go straight for the dopamine system, like if you’re, you know, but that’s not to say, like so detaching it from the AI safety alignment problem. It just puts such a big burden on the field and it’s kind of, it feels to me it detracts from the focus on what BCI could do to be really awesome for humanity if you just think about it from the lens of, well, if we, you know, it’s there purely to engage in the fight with ASI, that’s, it’s a different way to think about the problem, and I think there’s a lot of, yeah, it doesn’t do justice to the degree of amazing impact that just the BCIs on their own can, for both like people with a range of conditions today, or people who are they going to be able to expand their experience as we were talking about before.
Juan Benet
Yeah, like flourishing.
Tom Oxley
I do think I do think this is a mechanism by which we improve human potential and human flourishing, and that can be beautiful and good and positive and is kind of in a separate thing as to what do we do about ASI.
Juan Benet
Yeah, it’s going to be a very interesting next few decades, I think.
Tom Oxley
Yeah, I think the 40s is going to get interesting.
Juan Benet
Yeah. Yeah. Yeah.
Tom Oxley
I think stuff’s going to happen in the 40s.
Juan Benet
Yes.
Tom Oxley
Yeah. It’s pretty funny that this was well predicted by, you know, a number of people including Kurzweil and others. Like they just, yeah, they described like the 40s is when, the 40s. He just predicted that the singularity was going to happen in the 40s. He later, I think one of his predictions was in the late 20s or early 30s, and then orig,
Juan Benet
Yeah.
Tom Oxley
And then other predictions were in the 40s. Yeah. Yeah. Yeah. And I think he like, I don’t know the exact descriptions but he’s much more right than I think everybody else gave him credit for at the time. Like I think when he was first publishing all this stuff, everyone was like that’s not going to happen. And now we’re like sailing into mid-20s and we now have LLMs that can reason quite well.
Juan Benet
Yeah. No, I’ve always been really inspired by his writing.
[1:06:55] The optimistic vision: unlocking the subconscious
Juan Benet
What’s your kind of optimistic vision for the future? Like what can we unlock as a species?
Tom Oxley
I think there’s a lot of suffering in the world from a lack of self understanding of the way that your brain has architected itself on account of all the traumas that you’ve collected. I’ve got a four-year-old daughter and she’s probably starting to form memories around now. She’s been a person for several years now. It’s so weird that like you walk around for 4 years and you can’t remember what happened and yet things that happen, you form these like fundamental basic philosophies around the world based upon what happens early in your life. That’s just the beginning of what becomes like the way that you are built. And then you know people get therapy for a lifetime trying to unlock, and we all have these very predictable same triggers that you then spend your life trying to manage in your relationships around you and probably going to war over and all sorts of things. So I think that this technology, yes I think it can help people who have injury or disease overcome that. I think it can help people communicate, but I think the things that it could do that nothing else will do is unlock those subconscious domains within us that there is no other way to do that. I think that could have a huge profound positive benefit on society. Kind of like I keep thinking about a mirror because like I when the mirror was first invented, but like if you hold a mirror up, you can just if you could hold up a mirror to your own actions, they’re very hard to manage. They’re very hard to reflect on and they’re very hard to change. I think that’s one of the most powerful things it could do.
And then I do think you talked about creativity. I think the ability to share nonverbal creative outlets, like almost chaotic, that’s the other thing about the subconscious, there’s this like you got every night we go to sleep, there is this, it’s not fully chaotic like there are these sort of archetypes bubbling deep underneath, some which are more pronounced in us than others, but there’s very predictable archetypes told in story form in fairy tales, and the ability to get down to that level of like chaotic storytelling that’s happening deep within us as this kind of engine underlying ourselves. Like it sounds a little bit weird and crazy, but there are these like drives underneath the way that our brain can communicate now that are just not at all not seeing the light of day at all. So I think there are going to be mechanisms of storytelling, of creative outlet, of communication, of emotional integration, of connection, of productivity, of all human things. These are all human things. You know, when people say, “Yeah, but that’s like very unnatural.” It’s like, well, actually, you know, even the development of speech, when do we, when did we start talking? Like a million years ago.
Juan Benet
A million years ago. Yeah.
Tom Oxley
Probably depends on how you count it, but like more advanced speech.
Juan Benet
Yeah.
Tom Oxley
Half a million years ago. So, that wasn’t like the brain, like it evolved to that state. But like we’re starting, we started to use it in a very different way. And you’ve now got like if you look at the brain like you’ve got this huge amount of processing power and then it comes through this tiny band of fibers down your brain stem called the pons. It’s like the output of the motor cortex. If that gets damaged like you can’t, you’re locked in and your whole brain is working fine. That’s like, you know, the patients that need BCIs the most. But it kind of tells you that there is this whole world going on in there that we have this kind of not very good mechanism of expressing that I think the BCIs could bypass. And I think at that point we get to levels of self-knowledge, interaction, communication and hopefully positivity that we couldn’t do before and all the bad side of humans as well. But humans are humans, imperfect. But I think this becomes a tool of self-expression fundamentally.
[1:10:54] Building a company: 696 no’s
Juan Benet
Just in terms of building a company, like you’ve been able to span the whole R&D pipeline, like going from, you know, early science to building a device and figuring out the possible applications and developing it, and like building a team and creating a company, and like, you know, fundraising for it, and like steering the ship, and there’s enormous amount of work of spanning the whole pipeline to be able to do something like this. How did you learn all of this landscape? Like do you kind of just learn by doing, learn by studying others? Like what sort of pointers you would give out to other people following in your footsteps of, you know, how to get there?
Tom Oxley
So maybe going back, research, jump from research to entrepreneur was, research is asking questions and being very curious and hoping that the question that you’ve asked and the discovery that you find will be, I think, significant enough to feel like you’ve really made a difference. The difference with pursuing development or entrepreneurialism was you then have to choose one thing that you think is worthy to then dedicate yourself to. In the case of me, it’s been like 12 years, 15 years or something. And that’s tough because you stop asking the same question and then you start like banging your head against a brick wall to try and get things right over and over and over. Like pitching, I’ve done, I’ve done five, six, 700 pitches now. And I remember early on when I started doing, I’m like, “Oh, why? I can’t say the same thing again. This is absolutely exhausting and I hate the sound of my own voice.” And but then you’re like, “Well, you know, that time I used a slightly different word and I got this reaction.” And so then you have to sort of enjoy the storytelling and like the feedback, the interaction really matters. So you have to enjoy the performative nature of it and learning. So that that was a big jump. I think the resilience, I think you’re just a resilient person or you’re not. I don’t know how you learn that. So, that just probably comes from childhood. But being told no over and over and over and then failing over and over and over and being kind of stubborn and driving forward despite that, that’s a really important, a lot of people stop. A lot of people give up. A lot of people believe cuz you speak to like that’s, we’ve done, actually we’ve just announced the series D. So that’s four rounds of financing, so that’s four yeses and like 696 no’s, and they’re really smart people, and if you start believing the really smart people, like of course I’m going to fail, why would I do this? So there’s kind of an element of stubbornness, but like, yeah, persistent stubbornness,
Juan Benet
contrarian,
Tom Oxley
contrarian, contrarian, I think contrarian and right perspective.
Juan Benet
Yeah, yeah,
Tom Oxley
and then, but that kind of clashes with building a team, because then like building a team is like a different challenge, you have to let people fail and you have to hand things off and you have to like trust people, and that’s also a very different skill set. The three things that I’ve reflected on are the three most important features are resilience, common sense, and tenacity. And then I think Peter Thiel said this, but you have to really look into yourself and ask the hardest questions of yourself. You have to be willing to really go into the ugliest worst side of yourself and take on the worst element and be willing to like work at it. A lot of people find that hard. Everyone finds that hard. But you have to take on the ugliest part and like and figure out how to turn it around because it will express itself as you go, and as things build, like that’s going to express itself, and you bring everything with you.
Juan Benet
Yeah, kind of like the companies tend to reflect the strengths and weaknesses of the founders, and so if like whatever your worst weakness is, the company’s going to have in spades, and so then you have to like figure out what that is and like work against it.
Tom Oxley
And then quitting, you got to quit things, and so, you know, people drop out of college, I had to quit medicine. I spent 20 years learning how to do those procedures. I came to New York and then I after 20 years getting like, I did a lot, I did medical school, I did internal medicine, I did neurology residency, I did a PhD, I did fellowship, and then I quit to go all, who’s done it has sacrificed something.
Juan Benet
Have you studied any specific founders or companies to like learn from their...?
Tom Oxley
Well, I mean I’m inspired by Steve Jobs, inspired by Elon. I mean Elon’s created brutal cultures in his company, but he’s like he puts the mission above everything. And that’s a pretty powerful way, that’s it’s grueling though, and it’s like having a family is an impediment to your absolute full blasting at work. So I think finding that balance has been a real challenge, and then Jensen and Nvidia is just an incredible leader. He’s a very different style.
Juan Benet
Do you learn from them by both, like I don’t know, watching their public discussions, or reading biographies?
Tom Oxley
I think reading biographies you learn more about what’s really going on.
Juan Benet
Yeah, and you also learn to pick apart like what seems to be like, you know, a good feature, and what are bugs, right?
Tom Oxley
You can, in learning about other great leaders, you can figure out like which of the pieces you want to take on. Well, Andy Rasdal has just joined this company. So Andy, he sold AB to Medtronic, became president of Medtronic. He went and started Dexcom. He’s had an incredible career. So I’m learning from him. He’s coming in in a chief of staff role here. He’s made me realize what I’ve been thinking about recently is the ability of a leader to stay, Brian Chesky from Airbnb, he’s great, the ability of a leader to stay high level but then choose the thing to zoom in on. You can’t zoom in on everything, but you choose the most important thing and then you go right down and you get to the technical bottom of it and then you probe until you get the questions that can’t be answered and then you just focus on that and fix that and then you zoom back out and then you go around, look again. That’s Elon’s secret. Like that’s what he’s, it’s unbelievable. He walks in, figures out the problem, goes straight down to the IC engineer, talk to them, and then zooms back out and then leaves, or fires a few people, promotes a few people, then leaves, comes back in a month. I can’t do that. But like that concept of being able to zoom out, zoom in. That’s really hard.
Juan Benet
Yeah. Marc Andreessen has a good description of this where like Elon will intensely prioritize solving whatever the company’s biggest problem is right now and hyperfocus on that and do that, solve that problem, and then move to the next one to the next one to the next one. And part of how, why that works for Elon is that he also has very strong management teams also, right? Like at SpaceX, he has Gwynne and a whole team that are able to do the parts of the function that he doesn’t want to do.
Tom Oxley
You know a lot of large organizations get the management structure becomes so ossified or strong that then it gets overprocessed, and then this Elon style ability to cut through all of that and get to the core problem and solve it is like becomes extremely extremely useful to be able to really refocus a team on the things that matter, and maintain, like they’ve got high turnover, but the ability to maintain the intense focus, the mission driven, but then handle a culture where there’s very high turnover, and it’s kind of you worry about failing, otherwise you’re going, you get it like that. That’s that’s that’s that’s hard to do.
Juan Benet
The kind of speed of development that Elon is able to achieve is extraordinary. Steve also drove that. The iPhone was kind of, they decided to do the iPhone and announced it like 2 years later. It was like a 2-year extreme sprint. The iPod, when Tony Fadell joined Apple, the iPod was built in like 9 months or so, like going from, you know, Tony Fadell joins to the iPod, is, I think shipping in 9 months, or at least announced, but I think it’s shipping. It’s extremely fast development cycles, very difficult to drive a team with to that kind of velocity. A lot of people question whether or not the velocity matters that much. And in reality, what ends up happening is if you don’t run a team at high velocity, all of the timelines will start expanding by very large factors and then whole ranges of things just become impossible. So the really extraordinary R&D companies achieve this extremely fast clock cycle on the whole thing, and they’re able to learn and develop so fast relative to others that they’re able to like really accomplish great feats because they’re just able to accomplish so much per unit time, and it’s just so hard to drive that kind of fast R&D in general, and to keep kind of teams very motivated to these kinds of goals.
Tom Oxley
And with medical devices it’s over a sustained long period of time where you’ve got impediments to rapid cycles because you if you change too much you back to the drawing board and you have to go back to a very long cycle of benchtop, animal studies, human testing.
Juan Benet
Yeah. So you have kind of these longer horizons and you’re trying to keep things moving in really fast pace but gated in a way which is it’s it’s feels grueling. When you think back on the whole process of like just the core invention to developing the first prototypes to like now at the stage that you’re at, or even looking ahead, what stage do you feel is the hardest or highest risk, or what would you change about the nature of how we organize ourselves as a world? You certainly mentioned the slowness of the regulatory structures. What other things come to mind?
Tom Oxley
With regulatory innovation comes risk. So there’s one question of like as a society, how tolerant are you of risk of something happen? How much ethical responsibility do you give to the physician doing the consent for the procedure versus having a more paternalistic regulatory body? In Australia, the regulatory body isn’t paternalistic like the FDA. They actually hand the responsibility at the level of the hospitals with the physicians, and they scrutinize the consent form, and so they make a determination there, whereas the FDA has a very high bar at a federal level. Trump’s spoken a lot about deregulation. What that would mean is taking on a little bit more risk. So have we got the risk level right in BCI? I’m not sure. I haven’t seen anything bad happen yet. So that that’s one thing that’s been on my mind. We’d set the goal of delivering electronics without cutting the skull. So we had a lot of early failures. That that was, I think, in the very early days though it was very, it was because it was research, it was a little bit more, there’s not, it felt like we didn’t have much to lose, and so we were throwing caution to the wind a little bit more with how we were doing designs, how we were trying new things. As we’ve gotten on now, we’ve now got a lot more to lose. And any little one little mistake or one little error on the manufacturing line, one little problem can slow down everything. So now it’s a very different skill set of getting the requirements right, getting the manufacturing reliable, getting the testing right, not over testing, not having too many requirements. I honestly don’t know how we do this quicker. I will say, I was in China recently and I was blown away.
[1:21:35] Losing the BCI lead to China
Like there is a top-down strategy in the government, BCI, robots, AI, energy, solar energy, the CCP released the strategy, it therefore immediately become social capital to be working on you know that topic, and I was in the hospital, and the chairman of the hospital has regular weekly meetings with the CCP, and they’re like, so you know what what are you working on that’s aligns with the policy of BCI. Yeah, I’m working on BCI. What are you doing? So, the galvanization of the society towards these strategic imperatives, and then the, I think it’s called the NMPA, the Chinese FDA, they have the mandate. The hospital ethics committee have the mandate. Now, I don’t, you know, the ethics of it is questionable there. Like is that going to impact safety? But the top-down alignment on how to make this move fast was unbelievable.
Juan Benet
Do you have a sense of what the goal landscape looks like and what approaches they’re pursuing?
Tom Oxley
There’s a broad vision that BCI intersects with AI and results in technological superiority of the Chinese people and therefore we have to win. And I don’t think you’ll hear the US government saying that. I think you’ll hear venture capitalists saying that. I think like there’s an industry saying that, but the speed with which that industry is moving in China is going to outpace the US, you know, in the next five years. I think they’re still behind, but they’re moving at a rapid pace and there’s lots of capital flowing now. Now, they don’t have the reimbursement system. They don’t have the healthcare system. They don’t have, you know, there’s lots of other things that are maturing in China. But maybe like in an ideal world in the US, there would be like, Israel does this well. Israel has like a department of strategic innovation. They actually decide, here’s what we’re going to work on. I guess US is doing that a little bit, but in the 70s, and in the 60s and 70s, that’s kind of how it really worked in the US, but no, I feel like in the 60s and 70s there was like, I was even reading Benjamin Franklin, like even Benjamin Franklin had like a, became, sorry, it was Jefferson, was Jefferson the third president I think he was, it was Jefferson, and he came in and he like even said, we’re going to just spend on a scientific strategic initiative is like it galvanizes people, it makes them real. You know, it’s, we need, we need a bit more of that in the US, and obviously lately there’s the NIH has taken a big hit. But BCI, like, we’ve got a, US is way ahead in BCI, but we are, we, but we could lo the lead, we could lo the lead, we are going to lose the lead, we will lose the lead to China unless we have a significant acceleration. Yeah, and AI is great, AI’s accelerating massively, but I feel like I don’t think, you know, BCI’s been, I don’t think the potential for BCI has been recognized at all.
Juan Benet
Do you think there’ll be like a Sputnik moment where China unveils some interesting significant capability and the US just immediately reacts?
Tom Oxley
I haven’t thought of that. That could definitely happen. There’s a lot of skepticism when the reports come out, like was it really, was it really doing that? But I think that I could definitely see that happening in the next 5 to 10 years.
Juan Benet
It might also be, you know, too late in the game when, if you wait until that Sputnik moment happens.
Tom Oxley
But oh, the US can galvanize pretty quickly if it wants to.
Juan Benet
Yeah, definitely. And it’s being politicized a little bit now because of Neuralink and Elon.
Tom Oxley
So it’s, you know, I’m noticing some kind of, you know, political now impacts on the space, particularly emerging around privacy and the treatment of neural data, which seem to be politicized. That’s unfortunate. I think something that will help there is a number of the other companies coming out with their devices over the next two to three years and fleshing out the space, because today Neuralink is by far the most visible and the loudest, and so it’s easy to think that that’s most of the space when in reality it’s just the one company that is very public about everything that they’re doing, whereas there are many other companies that are developing a range of technologies. It’s just kind of more the traditional medical device pathway, or biotech oriented direction, where you kind of keep everything much more private until you have a moment to, you’re getting close to releasing it commercially, and then then you have like this big public splash. Something I think would help a lot here is much more public video about patients using BCI, like just so that people have a much more clear view into the benefits and the impact on a daily life of kind of what happens. There’s just this incredible set of videos. One that was very moving for me was watching a woman getting a cochlear implant turned on for the very first time, and she’s hearing for the very first time, and it’s just this incredibly moving moment of the change in perspective and experience that is made possible by that. And so I think collecting those kind of stories and being able to help people understand the scale of impact here, that would be very helpful.
Juan Benet
Any last words or advice for other folks building in the space or dreams for the future?
Tom Oxley
Well, I think the differentiation in BCI companies right now is playing out in the electronics, in the materials, in the delivery, the medical delivery, in the physicians. So I think occupational therapists are going to come into the sunlight with, I think the occupational therapists are going to be the therapists of BCI. I think rehabilitation physicians are going to have a new tool that’s very exciting. I think neurologists are going to have an ability. So I think I can see a lot of different subsets of medicine that are going to get very excited about and galvanize when all this comes together. And I’d encourage anyone in any of those domains to kind of begin to read and get involved, because I’m still surprised at the low number of people in the clinical domain that are kind of putting their hand up right now, and the ones that do are going to have an ability to become experts. I think, like I said before, I think it’s going to go slow, so slow, and then I think in the next, probably not in the next 5 years, but maybe within 5 to 10 years, it’s going to suddenly hit a hockey stick, and it’s going to suddenly be around, and there’s going to be a lot of it for entrepreneurs. I’m seeing a lot of companies try to do software plays primarily. I think that’s interesting. I think every system generates very different data. The neuroi field is super interesting. I think it seems to be emerging primarily at NeurIPS, the conference in December that’s coming up, that seems to be a hotbed of, you know, convergence of ML, AI, neuroscience, computational neuroscience, which is super cool, foundation model development, that seems to be emerging as a really super interesting academic heart of BCI. Yeah, there’s lots of different entry points to look at, and I just encourage everyone to get involved. It’s going to be a lot of fun. It’s going to be a very fun next decade or two.
Juan Benet
Yeah. Well, thank you very much.
Tom Oxley
No worries. Thanks for chatting about all of this.
Juan Benet
Thank you. I hope you enjoyed this episode. This is a new podcast, so we need your help to get the word out. Please like, rate, and subscribe on your favorite platform and share it with people you think would find it interesting. Thank you. See you next time.
