BREATH

Breath: The New Science of a Lost Art

An Interview with James Nestor

EDITORS’ NOTE James Nestor is an author and science journalist who has written for Scientific American, Outside Magazine, BBC, The New York Times, The Atlantic, National Public Radio, and more. He spent the last several years working on a book called Breath: The New Science of a Lost Art. Breath was an instant New York Times, Wall Street Journal, Los Angeles Times, Sunday London Times bestseller. Breath was awarded the prize for Best General Nonfiction Book of 2020 by the American Society of Journalists and Authors and was a Finalist for the Royal Society Best Science Book of 2020. Breath has been released in 35 languages and has sold more than one million copies worldwide. Nestor’s first narrative nonfiction book, DEEP: Freediving, Renegade Science, and What the Ocean Tells Us about Ourselves (2014), was a BBC Book of the Week, a Finalist for the PEN American Center Best Sports Book of the Year, an Amazon Best Science Book of 2014, BuzzFeed 19 Best Nonfiction Books of 2014, ArtForum Top 10 Book of 2014, New York Times Book Review Editor’s Choice, Scientific American Recommended Read, and more. DEEP has been translated into more than seven languages and was the basis for the Emmy-nominated Virtual Reality documentary, “The Click Effect.” Nestor has been an invited speaker at Stanford Medical School, Harvard Medical School, Yale School of Medicine, the United Nations, UBS, as well as more than 100 radio and television shows, including Fresh Air with Terry Gross, TheJoe Rogan Experience, BulletProof, ABC’s Nightline, CBS Morning News, and dozens of NPR programs.

Will you discuss the journey that led you to the study of breathing and writing the book, Breath: The New Science of a Lost Art?

I wish I could say that I had a grand plan, but what happens a lot in journalism is that you stumble onto one thing that leads to another thing which leads to another. This is exactly what happened with my interest in breathing. I had been suffering from a number of respiratory problems – bronchitis, mild pneumonia, wheezing – while I was exercising. All pretty common, and nothing too serious, but it went on for years. Every doctor I saw told me the only solution was to keep taking antibiotics or to be less active which didn’t really work for me. I discovered breathing as a way to first dampen the symptoms of my respiratory problems, then, after several months, all the problems I experienced disappeared completely. I haven’t had them since and this was more than a decade ago. But this was just my personal experience so I kept it to myself. As a journalist, I was not going to write a memoir about my breathing which, frankly, sounds awful, so I just filed it away until years later as I read more and more scientific research on breathing therapies and the profound effects they could have on asthma, snoring, anxiety, respiratory infections, and more. I also read about how poorly the modern species was at breathing. We’re the worst breathers in the animal kingdom. After five or six years of doing very casual research, I went to my agent and told her that I had an idea for a new book. She asked me what the focus would be, and when I said it would be about breathing, she thought it was one of the worst ideas she had ever heard. It took another year of convincing her. So, yes, in many ways the book was an overnight success that took about 12 years of constant work and hearing the word “no” from everyone.

There is a major focus on the impact of breath and breathing today. Is the conversation taking place the right conversation and what do you feel are the key elements that need to be addressed?

Each of us has our own breathing fingerprint. We all breathe in a unique way, and the vast majority of us have unique breathing dysfunction. We get it wrong in our own individual ways. Along these lines, everyone responds slightly differently to breathing retraining and therapies. When you hear people say that breathing cures chronic panic attacks, asthma, autoimmune issues, or depression, it is true that it has worked tremendously well for some people, but that doesn’t mean everyone is going to have the same transformative response. The good news is that improving your breathing – just like improving your diet or exercise regimen – will only have benefits. It’s always a net gain. For some people, those benefits will be subtle while, for others, it will dramatically change their health and change their lives. I’ve seen

this in hundreds of people, and experienced it myself, which is one reason I kept digging into this research for so many years, even while my journalist friends and agents were mocking me the whole time.

Do you feel that there is a strong awareness and understanding of the impact and benefits that breathing can make?

Everybody breathes, just like everybody eats and everybody sleeps. I think that there is considerable scientific evidence showing that it’s not just that you are eating food that’s important, it’s what James Nestor you are eating, and how much. The same goes for sleep. It’s not just that you go to sleep every night that counts, but how you sleep, how long, what ratio of deep sleep, REM, and light sleep. We know our diets and sleep are essential to good health, but fewer people talk about breathing. They are just focusing that we are breathing, not how; which foods, how much – same goes for sleep. But how we breathe is as least as important as what we eat and how we sleep. Consider, we get the majority of our energy from our breath, not from food and drink, but from air. How you get that energy will determine so much of your mental and physical health, and even your longevity. The science around breathing has been there for decades and decades, and while it was new for me, it was not new for people who have been studying it, mostly to little fanfare, for the past 50 years. These researchers were at top institutions – Stanford, Yale, Harvard – and constantly publishing in academic journals, but the general public never got the message. Most of what I just have mentioned was documented at Stanford in the 1970s, and even earlier. My role in writing the book was to try to give those people a little louder bullhorn and to put their research together so that people might listen, because what they were saying impacts every single person on the planet.

As you look at your journey in writing this book, were there many surprises along the way?

Yes, to say it mildly. In nonfiction, you write a book proposal and then you pitch that proposal to secure an advance, which is usually a pittance of cash to just get by until you finish the book. I spent about six months writing up a 60-page book proposal, and at the end I thought I was all set, but I did not realize that the real story behind breathing was not two layers deep, but 10 and 20 layers deep. It wasn’t anything you could really find on the

“The good news is that improving your breathing – just like improving your diet or exercise regimen – will only have benefits. It’s always a net gain. For some people, those benefits will be subtle while, for others, it will dramatically change their health and change their lives.”

Internet. I had to keep rewriting this book over and over again over several years because I was discovering new things that completely rocked the foundation of this research. Ninety percent of this book was cut and thrown out. That hurt, but it’s just part of the process. At the end of the day, I wanted to present this story to be accessible to the general public. What good are scientific discoveries about human health if the vast majority of humans never hear about them? What I wrote documented my own path into this field of research: the most revelatory angles and facts I found over so many years of plugging away.

Readers notice that about a quarter of the book is End Notes filled with several hundred scientific references. I told my publisher that nobody was going to believe the content until they saw the research for themselves, and saw where it was coming from. But even with all that, even though I included photographs, X-rays, and hundreds and hundreds of clinical studies, there are still people who will not believe that breathing can really have a big effect on asthma or improve the curvature of your spine or reduce autoimmune diseases. At the end of the day, I learned that people want to believe what they want to believe, and that’s perfectly fine. My role as a journalist should never be to try to convince anyone of anything. My role is to objectively and honestly present information and people can do with that information what they want. But before you doubt something and call it baseless, at minimum, do your research, remove your politics, and look at the data. So often we learn that things we thought were impossible 20 years ago are now accepted as self-evident.

How important is it for the focus on breath and breathing to be introduced and taught at a young age?

I have been lucky enough to speak at a number of schools and it is amazing how the kids respond to this. I have not seen a group of kids not become affected, even after only a few minutes of learning simple breathing exercises. While a lot of kids may not focus on their health, they do focus on how they look and if you are able to show them what is going to happen to their face if they mouth breathe – how that is going to influence the downward, sloping, structure to the face – then they start really paying attention. Teachers are also very interested in breathing since it is a great way to get the kids to calm down and focus.

One of the things that many of us have lost track of is the number of kids suffering from sleep disorders or other respiratory issues which are often misdiagnosed. It’s a catastrophe. In my opinion, these breathing issues are at the center of a public health crisis. We’re dealing with all the downstream impacts of this and still, so few people are focusing on it.

You participated in an intensive breathing study at Stanford. How were you impacted by the study?

The majority of people breathe in a dysfunctional way, and upwards of about 50 percent of us are mouth breathers; meanwhile more than 60 percent of us breathe through the mouth while sleeping. People don’t realize that the symptoms of headaches and bad sleep and problems exercising could be tied to how they are breathing, specifically the pathway through which they inhale and exhale air. I am not a habitual mouth breather, but I made myself one for this experiment, as did another volunteer. We knew our health would suffer – the science is clear on that. But what was shocking was how profoundly it all happened, and how quickly. Within a day or two we were complete wrecks: our sleep, mental abilities, physical health, all of it. You can only imagine all of the kids and adults that are experiencing this laundry list of problems that they think is just part of growing up or part of growing old. What I learned is a lot of these chronic maladies are tied simply to how we breathe.

Who do you feel has the responsibility to lead the effort to educate and inform about this issue?

You could ask this same question about nutrition – is it doctors, the FDA, the government, teachers, parents? I would say all of the above. The same with breathing. It’s all our responsibility. A lot of people put the blame on doctors, which I find unfair. Many doctors are seeing five, ten patients an hour – they just don’t have the time to look at their breathing, ask them about their sleep, teach them some exercises. Our medical system is not set up for the doctors to do this. I know this because there are doctors in my family, and I’ve talked to dozens and dozens of other doctors and most say the exact same thing. They are as frustrated as the patients. It will take a collective effort to drive awareness and change in this area.

How important is it for you to make the distinction that you are a journalist telling these stories and not a breath therapist?

It is very important to me. And it’s a struggle – not for me to set clear parameters, but for the general public to realize I am not the person to reach out to in order to diagnose and treat your chronic illnesses. People come up to me all the time and share the most emotional and desperate pleas: how a child is suffering from ADHD and not getting better, how a grandparent has COPD, how their wives snore, how they have sleep apnea and want to get off CPAP. As a human being, I, of course, want to help these people, but as a journalist that is not my job. I don’t have the capacity, for one, and I also am not qualified to prescribe treatments. The best thing I can do is refer them to people who are leaders in the field, whether it be a pulmonologist or an ENT or dentist. I am not here to give medical advice. I am here to give the leading medical professionals and researchers in these fields a louder voice.

It is really hard since I have seen firsthand how many people are struggling with

respiratory disorders and not getting help, or are getting the wrong help, and now their health is really deteriorating. Hopefully, if I have been able to do anything with this book, it has been to offer readers a little more perspective and connect them with people who are certified and able to provide the care they so desperately need.

Did you realize as you worked on the book that it would make the impact that it has on so many people?

I wish the answer was yes, but it is a resounding no. I think of my wife, who had to watch me rewrite this book over and over, then watch my deadline slip away by months, then a year. I was bringing in no paychecks during this process – writing this book was a 24/7 job for several years. Even my wife, after seeing me rewrite the book for the fourth time and being two years late on the delivery of the book and not getting paid for four years, questioned what I was doing writing this book on breathing. She definitely got nervous when I went to the Paris Catacombs on research, and traveled to talk with all these dentists. She kept asking me, “This is a book on breathing, right?” I told her yes and that it would all make sense in the end. The truth is I had no idea how I was ever going to put the pieces of this puzzle together. And when it was all done, I honestly did not know if anyone was going to care. These are doubts every author has, and I had them in spades at the end of this process.

So, the book was done in late 2019, and printed shortly thereafter. In publishing, you are basically locked in a year in advance. Then, a few weeks before the release of the book, the world was bludgeoned with COVID. We certainly had no idea that the book would come out six months before the onset of COVID, a global respiratory pandemic. Humans are reactionary. We often only care about things once we’ve lost them. The pandemic raised people’s appreciation of breathing, especially since so many tragically lost their ability to breath during this time. If there is any silver lining to the last two awful years of COVID, it’s that I hope it’s made the public more

“If there is any silver lining to the last two awful years of COVID, it’s that I hope it’s made the public more aware and appreciative of the wonder, and necessity, of healthy breathing. This public health crisis shined a light on the importance of breath and breathing to a person’s well-being.”

“Once you see what breathing can do for you, and you don’t have to wait weeks or months to see it – after a couple of minutes of breathing differently and breathing in a healthy way you can experience the transformation that happens in your body.”

aware and appreciative of the wonder, and necessity, of healthy breathing. This public health crisis shined a light on the importance of breath and breathing to a person’s well-being.

What do you want people to take away from the book?

The credit for the book needs to go to the researchers who have worked largely in vain, in silos, for decades and decades. The area of mouth breathing was researched in the 1970s and there were hundreds of papers published, but no one listened. The issue of breathing dysfunction and respiratory disorders are a global pandemic of its own kind, and if the book is able to help a few people out, then that to me is the highest compliment; if it helps raise awareness for that even a little bit, then that to me is the highest compliment – it is amazing. If the book is able to help a few people, that is even better.

You have spent your career as a journalist and focus on science and data. With the debate over fake news and truth in journalism today, what would you tell people who may be apprehensive about the importance of healthy breathing?

I think it is great that the public is questioning a lot of things because much of what we have been fed for a long time is incorrect. If you look at what we have been told about nutrition, or the safety of toxins in the environment, and to some extent medicine, we now know that so much of what we’ve been told is wrong. A doctor told me that more than 50 percent of what we’ve known about medicine throughout history has been proven wrong. That includes right now. So, it is healthy to question things, because that’s how you move science forward. What is a healthy diet, what we eat or, this macho culture saying that all we need is three hours of sleep – so much of this does not have our health and well-being at the center and it is good that people are questioning these things. At the same time, it is really hard to find the truth because there are so many voices out there.

One of the things that attracted me to the topic of breathing was that is easy to measure, there are no negative side effects, and you can experiment on yourself for free, anytime, and see what works, because what works ultimately comes down to personal experience and what works for you. Unlike a diet, or exercise, which can take weeks or months to show real benefits, the effects of changing your breathing can happen after a few minutes, or seconds. You feel what happens to your mind, your body, your clarity. It’s not a placebo effect. This is you hacking into your biology. You can measure it with blood pressure, HRV, even brain waves, stress tests. Once you see what breathing can do for you, and you don’t have to wait weeks or months to see it – after a couple of minutes of breathing differently and breathing in a healthy way you can experience the transformation that happens in your body. If you can elicit such a powerful and beneficial response after just a few minutes, just imagine what will happen after a few hours, a few days, a few weeks, a few months, a few years. I have seen what happens. I have seen what this can do for people. I think that once people see it and feel it for themselves, they don’t need any more convincing. It is self-evident because it is not something that is happening in your mind, it is biology.•

Advancing Healthcare

An Interview with James Flynn, Managing Partner, Deerfield

EDITORS’ NOTE James Flynn joined Deerfield in 2000 and is responsible for the management of the firm. Under his leadership, Deerfield has built deep healthcare information expertise through the Deerfield Institute; expanded its investment capabilities to include venture and private structured financings; established the Deerfield Foundation to contribute toward the health and welfare of disadvantaged children; created Deerfield Discovery and Development, LLC, which organizes Deerfield’s discovery research efforts; and founded a healthcare innovation center at 345 Park Avenue South in New York City. Before joining Deerfield, Flynn was a top ranked analyst at Furman Selz, covering pharmaceutical and medical device companies. Prior to that, he served as Vice President of Corporate Development of Alpharma Inc. He began his career in healthcare investing at Kidder, Peabody & Co., where he ultimately served as a senior analyst covering the specialty pharmaceutical industry. Flynn served as the Chairman of the Quality Committee of the Board of Trustees of Continuum Health Partners until its merger in 2013 with Mount Sinai Health System, where he continues to serve on the Board of Trustees. He is Chairman of the Board of Trustees of the New York Academy of Medicine and is a member of the University of Michigan Life Sciences Institute Leadership Council. Flynn holds a BS in cellular and molecular biology and economics from the University of Michigan and an MS in biotechnology from Johns Hopkins University. FIRM BRIEF Deerfield Management (deerfield.com) is an investment management firm committed to advancing healthcare through investment, information, and philanthropy. The firm works across the healthcare ecosystem to connect people, capital, ideas, and technology in bold, collaborative and inclusive ways.

James Flynn

Will you discuss Deerfield’s history and how the firm has evolved?

Deerfield was founded in 1994 by a small, collegial group of very senior people who had been leaders in the industry and specialized in healthcare. They had started the firm because they felt it would be fun and meaningful, and had planned to retire in three years. Most of them did, in fact, retire after three years and I replaced one of them. Deerfield became a successful firm with an enjoyable culture to work at, and we had several people who were interested and passionate about pursuing our mission to fundamentally advance healthcare. I took over the leadership of the firm in 2005. We have spent the past 20 years on a journey to take the roots and foundation of Deerfield and evolve into an integrated, diversified organization which we believe is fundamentally advancing healthcare through supporting both forprofit as well as not-for-profit work.

How do you describe Deerfield’s culture and what do you look for when bringing new talent into the firm?

I think a lot of investment people are in the guru business, thinking they are the smartest and know what is best and where the market is going – that is not actually a business. You have to think about it as a business, and businesses need to evolve to maintain a margin. If you have the exact same business model with many more competitors, either your margin goes away or you need to innovate in some way. We have always tried to ask what tools we can apply to do things differently or better, including our new building in New York City.

For me, when attracting new talent, people need to have two things: they have to be competent, and they have to care. If those two things are true, you can start anywhere and move ahead because you make observations over time about what you can do better – if you care, you adapt, and if you’re competent, you succeed. We focus on building a culture with people who care about improvement and doing things the best they can, and who are capable of doing that. If you are constantly elevating in lots of different ways, you actually get somewhere.

How important is brand awareness and brand recognition for Deerfield?

Brand is important to attract good managers and good scientists. Deerfield is still not that well known in some innovation circles, but we are working hard to get our message out to the people it is important for us to reach.

Deerfield acquired the building at 345 Park Avenue South in Manhattan and has invested heavily in transforming the building. Will you highlight the building and the important role it will play in Deerfield’s future?

I think it is super important. The building allows us to integrate the capabilities of innovators from academia, government, industry, and the not-for-profit sectors to tackle unmet needs in healthcare. It is exciting to create an environment in which innovative thinking, groundbreaking advances in scientific discovery, and the development of new paradigms of patient care will occur every day.

Healthcare is converging – even if you are developing a drug or a device, someone has to pay for it, someone has to prescribe it, someone has to take it – and with everything moving toward value-based care, data becomes more important, remote monitoring becomes more important, and remote communication becomes more important. The point is that if we went

“We have spent the past 20 years on a journey to take the roots and foundation of Deerfield and evolve into an integrated, diversified organization which we believe is fundamentally advancing healthcare through supporting both for-profit as well as not-for-profit work.”

CURE – Deerfield’s innovation campus at 345 Park Avenue South in New York City

back to when I began my career in the late 1980s, everything was siloed. Today, it is all integrated and, in the future, it will be even more integrated so part of the purpose of this building is to integrate all of the different components of care to get to the future, because the future offers much better and much cheaper care.

We will host many events in the building where different constituencies will be placed together to learn about other parts of the health system. Big companies need small companies for innovation, and small companies need big companies for capital – we will bring these companies together for events in the building. We are also interested in health policy and the latest science so we will also hold forums addressing these areas.

We think about this as creating an ecosystem that reaches beyond walls and plays a role in influencing the future of healthcare.

What was your vision for creating the Deerfield Foundation in 2006 and how does the Foundation focus its efforts?

I could not see being in a financial business for only financial reasons being fulfilling at the end of the day, and if you think about healthcare, while the for-profit part is going to take care of a lot of the challenges, there are still a lot of areas that do not lend themselves to the for-profit model. The majority of drugs that have come to market have been developed in a university originally, which is a not-for-profit entity with different motives and a focus on being published. We have approximately 20 research collaborations where they can publish.

I have always felt that the Foundation could play a meaningful role in our mission of advancing healthcare.

What are your views on the state of healthcare and what needs to be done to meet the healthcare challenges of the future?

Under the surface, healthcare is changing really fast. You only have to go back about 15 years to see a time when a patient would visit the doctor and the notes would be written on a piece of paper and put into a file, with no way for other doctors to access that record. Today, everything is on electronic medical records so you can access patient records quickly and efficiently in order to integrate care which leads to better outcomes.

It is easy to be optimistic in healthcare right now because every disease is a finite puzzle with a finite number of pieces, and every day people are turning pieces over and the more you can see the picture, the faster the puzzle gets put together. There is great visibility on tremendous advances in therapeutics, and it is the same thing in the quality of healthcare delivery. You can see how technology and innovation are making healthcare more efficient and convenient.•

Closing Gaps and Opening Doors

An Interview with Robert Rubin, Founder, The Bridge, and Chairman and Co-Executive Director, The Bridge Golf Foundation

EDITORS’ NOTE Starting out as a newspaper reporter in suburban New Jersey for the now defunct Red Bank Register, Robert Rubin quickly found his way to Wall Street, trading commodities and currencies for a quarter century for J. Aron, Drexel Burnham, and AIG before retiring in 2000. During part of that time, he sat on the Foreign Exchange Committee of the Federal Reserve of New York, as well as President Clinton’s Committee on Capital Budgeting. He is currently Chairman and Co-Executive Director of The Bridge Golf Foundation, a sports-based youth development program in Harlem affiliated with The Bridge, the acclaimed Long Island golf club which Rubin built and has operated since 2002. His wife, Stéphane Samuel, is Co-Executive Director of The Bridge Golf Foundation as well as its Director of Academics. Prior to creating the golf club, he owned and operated the site, which he acquired in 1981, as an automobile racetrack, also known as “The Bridge.” Rubin is the author of a number of books and articles on architecture and contemporary art, most recently Richard Prince Cowboy (2020). Rubin holds a bachelor’s degree in American Studies from Yale, an MA in Modern European History from Columbia University, and an M. Phil. in Theory and History of Architecture, also from Columbia University.

What was your vision for creating The Bridge and will you discuss this journey?

As the saying goes, “Life is what happens while you’re making other plans.” I discovered the racetrack – “The Bridge” – by accident in 1981 when I was going to have breakfast and parked my Ferrari outside the Candy Kitchen in Bridgehampton. Someone asked me if I was going to the Ferrari Club. I did not know this even existed and when I asked him where it was, he said “at The Bridge.” I didn’t know what that was either. So I went to see what was up, and about an hour after I arrived, I was told that the place would be plowed under for a hundred-plus lot cluster subdivision if a white knight was not found to save the track. I bought a blocking amount of stock in Bridgehampton Road Races Corporation and, after a long proxy fight, I secured control and took over operations. After a decade or so of losing money and dealing with aggrieved neighbors, town officials, and myriad lawsuits, I threw in the towel. You can’t operate an automobile racetrack in a community that doesn’t want it. I was trying to figure out an exit strategy in 1992 when someone suggested that I build a golf course with a few houses, which seemed like an interesting concept. Although it took ten years to get it done, we completed the course in 2002. I was originally going to bring in a partner who played golf (I didn’t at the time) and was a real estate developer (I wasn’t that either) but, in the end, I decided to do it myself.

Earlier in my career, I had gone to Wall Street with no background in economics or finance, and it worked out pretty well, so I figured that even without a golf or real estate background, I could do this too if I went into it with no preconceptions. Over time, it became what it is today – an idiosyncratic rather than generic high-end country club. It was a risky endeavor, with a few speed bumps along the way, but it worked out in the end. The Bridge is a cool, relaxed place where people want to be with their friends and families. It is a wonderful golf course, and the members are happy.

Will you discuss The Bridge’s membership and what you are looking for when bringing in new members?

In the beginning, I had no credibility – just a great piece of raw land – so I had to explain my vision to potential members at some length.

Today, new members come through existing members who recommend people they know for membership. The Bridge has evolved into its own unique ecosystem, especially after the clubhouse opened and people saw that we were changing the paradigm of a golf club. The membership is capped at 180 and we have a waiting list to get in.

How did the creation of The Bridge Golf Foundation develop?

This was also somewhat of an accident. About seven years ago, I went to play golf at Robert Rubin the Century Club in the middle of a week with an artist friend, a gallery owner, and a sports journalist. The journalist said that we should start a sports-based youth development program for golf because although other sports had them, golf did not. The barriers to entry for golf are rather high compared to, say, basketball. I thought it was a great idea, and funded its creation. About three years ago my wife, Stéphane, and I and decided it wasn’t evolving according to our vision so we decided to take it in hand and run it ourselves. We essentially rebuilt The Bridge Golf Foundation from scratch. It has been a very gratifying experience in the sense that it is a partnership between me, Stéphane, who leads our educational component, and Michael Sweeney, who is our athletic director and who has been at The Bridge for 15 years, most recently as Director of Instruction. The Bridge Golf Foundation is an intensive, year-round, multi-year program, organized around the game of golf but with a The Bridge clubhouse

strong academic component, for underserved young men of color. Our mission is to help these young men improve their college readiness, graduate from college, and move into the workforce well prepared for life.

We all work very closely with the young men and know them all very well. They come for three hours every day after school – 90 minutes of sports, 90 minutes of academics – plus the six week summer program. We know their families and school situations and spend time with them. I am encouraged by the way the membership of The Bridge has bought into the mission and work of the Foundation. Our location in Harlem has three golf simulators as well as classrooms, and many members come there and take lessons when the program is not in session. They see what’s going on there.

We’ve also built this fantastic residential complex at The Bridge that has 28 beds for the young men, plus an outdoor covered gathering/ dining area. The young men come and stay for the summer and work in the golf operations under Mike – the older ones also caddie and work as counselors-in-training.

Will you highlight the educational program at The Bridge Golf Foundation?

It is a holistic program. You have to remember that we’re a wraparound to the public school system which is under-resourced and not in great shape. The buy-in of our partner schools is critical to our success. We need to be in touch with teachers in real time. We are trying to provide these young men with everything that we have been able to provide to our own children in terms of college and life readiness. When you are running a youth sports development program, the sport is the easiest part. The educational component is tougher. We pay up to get the best tutors who show up consistently over years and are good role models for the kids.

Our focus is giving these young men a good educational foundation so that they can succeed. In the summer, we prioritize critical thinking which is an area they don’t have time for during the school year when they are focusing on their basic math and science classes. We have a six-week summer program with four weeks devoted to an intensive critical thinking workshop, followed of course by daily golf at nearby municipal courses. In terms of impact and outcomes, we have pleasant and unpleasant surprises. Some kids have blossomed against all odds. Others, who seemed very promising, have let us down. That’s how life is. We are doing our best within the limited time we have with these young men. We also have a mentor program. The mentors are instrumental in providing guidance, direction, and opportunity to these young men. We have a very long-term perspective. Right now, our oldest cohort are college juniors. We’ve had them in the program since they were in the eighth grade.

How have you approached the golf component of the program?

Golf is our sport and we use it as a vehicle for inspiring passion and discipline, and as a template for college readiness. Ideally the young men in the Foundation evolve as studentathletes, come to love the sport, compete at it in school, and carry their skill at the game into life – until the pandemic, we ran the Percy Sutton high school golf team in the Public School Athletic League. But if our young men are just able to become better students and thus are better prepared for college, then we have still done something meaningful. Everything we do is to build college readiness and life skills. If our young men are able to navigate living and working at The Bridge, then they’ve acquired some real skills ahead of going away to college.

Do you feel that this is a program that can be scaled?

We don’t rule out opening branches of Bridge Golf around the boroughs, but are not looking in the very near-term to scale it in a formal way. However, other programs in other cities are seeking us out because they have learned about what we are doing, so we are scaling informally, organically. We have had conversations with other golf clubs who are interested in our approach, particularly the strong educational component of our program.

Will you discuss your efforts to secure additional financial support for The Bridge Golf Foundation?

Up until now The Bridge membership has provided the primary financial support, but we are in the process of expanding our funding base and bringing in organizations that are focused on youth-based sports development. We’ve received grants from the Heisman and Heckscher Foundations. After three years at the helm, I feel we now have a convincing story to take to a wider audience.

What do you feel have been the keys to your success?

I had a very good education. I was taught how to think rather than what to think. To create The Bridge, I took a blank piece of paper and went on a listening tour asking people what was wrong with golf in the Hamptons and what was missing from the experience. I heard people say that golf courses were too crowded and too stuffy. I listened, and I showed up – that’s another big part of life.

Are you able to enjoy the process and take moments to reflect and appreciate what you have built?

When I am at The Bridge, I feel very proud of myself. When I am at the Foundation, I’m very proud of the young men.•

Golf simulators at The Bridge Golf Foundation facility in Harlem

A Race Against Time

An Interview with Daniel L. Doctoroff, Founder, Target ALS

EDITORS’ NOTE Having lost both his father and uncle to ALS, Dan Doctoroff founded Target ALS in 2010 in collaboration with Bloomberg Philanthropies and financier and philanthropist David Rubenstein to discover and accelerate treatments for ALS, an always fatal disease where there had been virtually no progress made since it was discovered 140 years before. Doctoroff and his team created a new collaborative model of research that has been a major catalyst to understanding the genetics and biology of ALS and has lowered the barriers to entry for new scientific discovery, and has helped to induce over 100 biotech, pharmaceutical, and venture capital firms to demonstrate interest in the disease.

Then in the late fall of 2021, Doctoroff was diagnosed with ALS. He stepped down as the Founder and Chief Executive Officer of Sidewalk Labs, an Alphabet company that accelerates the integration of digital technology into urban environments, and as the Chairman of The Shed, the innovative cultural institution on the Far West Side of Manhattan that he led since inception, to spend his last act on dramatically scaling up Target ALS.

Prior to forming Sidewalk Labs, he was President and CEO of Bloomberg LP, the leading provider of financial news and information, and before that he was New York City’s longest-serving Deputy Mayor for Economic Development and Rebuilding. Prior to serving as Deputy Mayor, he was a managing director at Oak Hill Capital Partners. He serves on the boards of the University of Chicago and Bloomberg Philanthropies. He is the author of Greater Than Ever: New York’s Big Comeback.

What was your mission and purpose in creating Target ALS and will you discuss its work?

My father died of ALS in 2002, and eight years later, in 2010, I watched my uncle die of ALS, so it was clear that in my family it was hereditary. I knew I had to do something. I was not so much thinking about myself, but I was thinking about my brothers, my cousins, my children, as well as the one in 400 people who will die of the disease if something isn’t done.

I started by bringing on board a few advisors, primarily researchers who had some experience in ALS and other neurodegenerative diseases, to analyze why there had been so little progress and to learn the positive lessons from successes in other diseases. We concluded a number of things: first was that this was a very complex disease, requiring a multi-disciplinary approach and most research was done in silos. We developed a concept of funding consortia around important problems and hypotheses in ALS research. Since 2013 we have funded 41 consortia, 25 of which have led to continuing industry drug discovery programs, six of which have already led to clinical trials, and five biotech companies have already

been formed as a result of the research we have funded. The second thing we realized is that you needed to bring new talent into the disease and to do that, you must provide researchers with tools, resources and data to do their work – things like biofluid samples, postmortem tissue, animal models and stem cells. So we established and funded eight core scientific resources that anyone in the world can easily access and all they have to do is pay handling costs. Those resources have now been used on 500 projects by scientists all over the world. The third thing is that, as you Daniel L. Doctoroff know, there is no treating or saving lives if there are not drugs, and drugs need to be developed by pharma and biotech companies. We set out right from the very beginning to engage industry in everything we do since we knew that this engagement would be critical to making real progress. We have seen an explosion of engagement in and understanding of this disease, and I am very proud that we have played a material role in that. We have become a respected neutral party in the ALS research ecosystem, which enables us to bring diverse coalitions together on projects like developing a toolkit of biomarkers, which are critical to early diagnosis, and better evaluation of clinical trials. We brought together 14 companies, 10 academic centers, 6 ALS organizations, and two venture capital firms to develop a process for identifying and using biomarkers. We have also built three partnerships with other diseases, one related to Alzheimer’s and two related to frontotemporal dementia. There is significant overlap on many dimensions among

“At the end of the day, this is a pipeline game, and you need to fill the pipeline with as many potential targets, based on strong science, as possible. This is why you need to bring in new talent, technologies and funding in order to gain a deeper understanding of the genetics and biology.”

“One of the reasons why I think that I have been able to handle this diagnosis is because I have been the beneficiary of such love and support from so many people.”

“Our goal over the next ten years is to play a material role in dramatically increasing the number of clinical trials, some of which will be successful in saving the lives of ALS patients.”

neurodegenerative diseases and we believe partnerships can bring in new talent and teach the ALS field new approaches.

To be clear, I am not the person who is leading our scientific efforts. We have a fabulous CEO, Manish Raisinghani, who has been the driver of our success, and a wonderfully committed board of directors and an Independent Review Committee, which selects and oversees the projects we fund. Both are comprised equally of eminent scientists from academia and industry who volunteer their time because they believe that what we are doing together is so essential.

When you are addressing a disease like ALS that requires a long-term focus and commitment, how important is it to have metrics in place to track the progress and impact?

At the end of the day, this is a pipeline game, and you need to fill the pipeline with as many potential targets, based on strong science, as possible. This is why you need to bring in new talent, technologies and funding in order to gain a deeper understanding of the genetics and biology. Ultimately, when you find those potential targets, they get handed off to pharma and biotech companies. Our goal over the next ten years is to play a material role in dramatically increasing the number of clinical trials, some of which will be successful in saving the lives of ALS patients. You need to have a big pool of targets to do that. No lives have been saved yet, but it is definitely coming.

We believe that lives will be saved, which are likely at first to be the genetic forms of ALS, which represent 10 percent of the cases. But our goal is that within ten years we will be in sight of everybody living.

At Target ALS and across the entire ALS field, we are in a race against time.

Do you feel that there is still an education process that needs to take place to build a deeper understanding and awareness of ALS?

There is a constant education effort needed. There are organizations that have been very effective at activating the community of ALS patients and their families which has turned into political power since this has resulted in pushing legislation and action. You can make a real impact with the right audiences by making people understand the disease in a more complete way. There is a large opportunity to better educate people. With one in 400 people dying of the disease, a lot of people are touched by ALS.

You are known to be an optimistic person. How has your ability to stay positive and to focus on opportunities helped as you face this disease?

I am always optimistic. I think I am also realistic, and I am aware that 80 percent of the people with this disease die within five years, and 95 percent will die within ten years. I watched my father die of ALS; my uncle die of ALS; my college roommate, Stephen Winthrop, died of ALS, so I am very aware of the likely course for me, but my nature is to look on the bright side of things. I do think that my optimistic nature is really helpful in this difficult situation.

I have been this way throughout my career. When I started New York’s Olympic bid, people thought it was crazy. I thought it was a great idea so I pursued it, and while it ultimately did not happen, many other good things happened in New York as a result of this effort.

One of the reasons why I think that I have been able to handle this diagnosis is because I have been the beneficiary of such love and support from so many people. When I announced that I received this diagnosis back in December, I received so many incredibly personal notes – about what I meant to people, about the impact I had on their career and lives. I felt that I went to my own funeral. As morose as that sounds, it actually sustains me.

I’ve been really lucky in my life. I have a wonderful family, tons of friends, have done what I wanted in my career and have started new institutions like The Shed. I have been very fortunate. I do not have any regrets. That helps to keep me positive. The reality is that I have probably only had one down hour cumulatively since this whole thing started.

With all that you have accomplished in your career, do you feel that your effort with Target ALS is your most important work?

There is nothing more important than saving lives. If Target ALS leads to that, then it will be the most significant thing I do in my life. It is also extremely personal because, forget about me, it is about my family.•

PURPOSE

Driving Environmental and Social Change

An Interview with Paul M. Donofrio, Vice Chairman, Bank of America

EDITORS’ NOTE Paul Donofrio is Vice Chairman of Bank of America and is a member of the company’s executive management team. Donofrio oversees the company’s sustainability activities and co-chairs its ESG Committee. He stewards the company’s efforts in support of its $1.5 trillion sustainable finance commitment, including oversight of its investments in Minority Depository Institutions and private equity funds through its $1.25 billion commitment to racial equality and economic opportunity, as well as investments made through its $1 trillion Environmental Business Initiative. He also has responsibility for the investment function of the company’s pension, which totals over $22 billion. In addition, the BofA Global Research department reports to him. He most recently served as Bank of America’s Chief Financial Officer for more than six years from 2015 to 2021. Before then, he held a number of key roles across the company, based in New York City and London. He served as co-head of Global Corporate and Investment Banking, head of Global Corporate Banking, head of Global Corporate Credit and Transaction Banking, co-head of Investment Banking, head of all Global Industry Groups and co-head of the Global Healthcare Group. His product experience includes M&A, global capital markets, including debt, equity, foreign exchange and derivative capital markets, as well as traditional banking products, such as loans, leases, global payments and deposits. Prior to joining Bank of America, Donofrio worked at UBS, where he was a senior member of the healthcare group from 1994 to 1999, focusing on biotech, specialty pharmaceuticals, and large cap pharmaceutical companies. Previously, he worked at Kidder, Peabody & Co. in the healthcare, technology and debt restructuring groups. A graduate of the United States Naval Academy, Donofrio served in the U.S. Navy from 1982 to 1988 as a naval flight officer. COMPANY BRIEF Bank of America (bankofamerica.com) is one of the world’s leading financial institutions, serving individual consumers, small and middle-market businesses and large corporations with a full range of banking, investing, asset management and other financial and risk management products and services. The company provides unmatched convenience in the United States, serving approximately 67 million consumer and small business clients with approximately 4,200 retail financial centers, approximately 16,000 ATMs, and award-winning digital banking with more than 54 million verified digital users. Bank of America is a global leader in wealth management, corporate and investment banking and trading across a broad range of asset classes, serving corporations, governments, institutions and individuals around the world. Bank of America offers industry-leading support to approximately 3 million small business households through a suite of innovative, easy-to-use online products and services. The company serves clients through operations across the United States, its territories and approximately 35 countries.

Will you provide an overview of your role and areas of focus?

My role as Vice Chairman is multifaceted. Alongside our CEO, Brian Moynihan, I oversee the company’s sustainability activities and co-chair our ESG Committee, as well

as steward the company’s efforts in support of our $1.5 trillion sustainable finance commitment, including oversight of our investments in Minority Depository Institutions and private equity funds through our $1.25 billion commitment to racial equality and economic opportunity and investments made through our $1 trillion Environmental Business Initiative. I have additional responsibility for the investment function of the company’s pension, which totals over $22 billion. My experience leading several lines of busiPaul M. Donofrio ness throughout my career has positioned me well to guide our company’s overarching sustainability activities which permeate everything we do for our employees, clients, and communities. I joined the company in 1999 and most recently served as Chief Financial Officer for more than six years. Prior to that, I was co-head of Global Corporate and Investment Banking, head of Global Corporate Banking, head of Global Corporate Credit and Transaction Banking, to name a few roles. My extensive experience across Investment Banking and Capital Markets, in addition to traditional banking products such as loans, leases, global payments and deposits, has helped me deliver the company’s capabilities and services holistically, while helping to guide clients in their environmental, social and governance objectives.

“As a global financial services organization, we have set tangible sustainable finance goals and made measurable progress in mobilizing and deploying capital to help drive environmental and social change. By working with the private sector and partnering with the public sector, we are addressing financing gaps where governmental or philanthropic funding falls short.”

“In 2021, Bank of America announced our goal of mobilizing and deploying $1.5 trillion in Sustainable Finance capital by 2030 in support of the 17 UN Sustainable Development Goals. Of the $1.5 trillion, $1 trillion is dedicated to the Environmental Transition to support a low-carbon economy.”

Will you highlight Bank of America’s sustainability activities and how these initiatives are engrained in Bank of America’s values and purpose?

As a global financial services organization, we have set tangible sustainable finance goals and made measurable progress in mobilizing and deploying capital to help drive environmental and social change. By working with the private sector and partnering with the public sector, we are addressing financing gaps where governmental or philanthropic funding falls short. Our sustainable finance strategy permeates what we do, in order to promote an inclusive, lower-carbon, enduring society for all.

Sustainability guides how we conduct our business and operations as well as how we pursue responsible growth across core lending and investments, equity and debt capital markets activities, advisory services, supply chain financing and management, daily operations, and engagement with internal teammates. As we consider our role in supporting a smooth transition, we continue to partner with global clients on clean energy, power generation and transmission, sustainable transportation with an emphasis on electric vehicles and sustainable fuels, sustainable food and agriculture, clean water and sanitation, and carbon capture and offsetting solutions, as well as more capital deployment in affordable housing, healthcare, education, minority- and women-led businesses, and underserved communities.

Today, Bank of America is not only the leader in ESG capital markets issuance and underwriting, but the definitive leading financial services firm in climate and social finance. Sustainability is embedded in our actions, our communities, our partnerships, our governance and our disclosures. For example, in December 2021, Bank of America announced an ESG-themed Issuance Framework to further enhance our issuances of green, social, and sustainability bonds and other ESG securities. The Framework aligns to Bank of America’s ESG leadership and the company’s sustainable finance strategy, which aims to mobilize and deploy capital in support of the UN Sustainable Development Goals. It builds upon Bank of America’s 2020 $2 billion Equality Progress Sustainability Bond issuance, which was designed to advance racial equality, economic opportunity, and environmental sustainability.

Will you discuss Bank of America’s $1.5 trillion by 2030 Sustainable Finance goal and how important are metrics to track the impact of this effort?

In 2021, Bank of America announced our goal of mobilizing and deploying $1.5 trillion in Sustainable Finance capital by 2030 in support of the 17 UN Sustainable Development Goals. Of the $1.5 trillion, $1 trillion is dedicated to the Environmental Transition to support a lowcarbon economy. The $1 trillion dedicated to Environmental Transition is a significant expansion of our initial commitment of $300 billion made in 2019. Since 2007, we have mobilized and deployed approximately $350 billion to environmental finance. Beyond the $1 trillion climate-related finance, the balance of the sustainable finance goal is focused on inclusive social development, scaling capital to advance community development, affordable housing, healthcare, and education, in addition to racial and gender equality.

As part of our $1.5 trillion by 2030 Sustainable Finance goal, we mobilized and deployed approximately $250 billion in sustainable finance capital in 2021, with approximately $155 billion financing the environmental transition and the remaining $95 billion for inclusive social development.

ESG is not just about spotting opportunities, but also about tracking impact and managing risk. Bank of America’s sustainability policies and standards are outlined in our Environmental and Social Risk Policy Framework, which is updated at least every two years or more frequently as issues develop. We also disclose ESG strategy, policies, and practices in our Annual Report and in other areas. These disclosures highlight our ESG impacts and actions, including the development of products and services to address the needs and concerns of low- and moderateincome communities, our financing in support of environmental and social goals, our progress toward public goals, as well as specific transactions that are escalated due to heightened environmental and social risks.

You serve as a co-chair for Bank of America’s ESG Committee. How is Bank of America addressing ESG and will you highlight this work?

Our ESG principles help define how Bank of America delivers Responsible Growth and contributes to the global economy, and helps us build trust and credibility as a company people want to work for, invest in and do business with. This enables us to serve clients, deliver returns for our shareholders and address some of society’s greatest challenges. We believe in business’ role in helping to create the scale needed to drive capital toward some of the world’s most important priorities.

Integrated across all lines of business, our ESG focus reflects our values, ensures we are holding ourselves accountable, presents tremendous business opportunity, and allows us to create shared success with our clients and communities. That includes financing to help small businesses adopt more sustainable business practices, and financing to help major corporations in all industries transform and decarbonize their business models.

The transition to a low-carbon economy means that a significant flow of capital will have to be put to work in an efficient and effective manner. Our clients will need advice and expertise, and we continue to invest to build this capability. To this end, within Global Corporate and Investment Banking, we have established a new team, ESG Advisory and Financing Solutions, to help our clients across industry sectors determine how ESG impacts their cost of capital and strategic initiatives and to assist them in navigating through climate transition. This new team is well-positioned to advise our clients, as Bank of America continues to be at the forefront of ESG financing – in 2021, GCIB was the number one underwriter of U.S. ESG corporate bonds.

Beyond sustainable finance, we continue to focus on stakeholder capitalism, economic mobility, advancing racial equality and economic opportunity, employee giving and volunteering and our support of arts and culture. As a core tenet of Responsible Growth, our commitment to being a great place to work means investing in the people who serve our clients across the world. To provide clients with the best service and to support the communities in which we operate, we must attract and retain the best talent, create opportunities for our teammates to grow and develop, and remain anchored to our long-standing D&I commitment. We believe with our teammates’ depth of expertise, resources and geographic reach, we, as a company, are uniquely positioned to help advance strong economies and social progress globally.

Bank of America made a $1.25 billion commitment to racial equality and economic opportunity. What was the vision for this commitment and how will you measure success for this effort?

Through Responsible Growth, we deliver for our teammates, clients and shareholders and help address society’s biggest challenges. One example is our work to advance racial equality and economic opportunity. That said, we have worked broadly in these areas for many years. Internally, this is core to being a great place to work, hiring and recruiting diverse talent to ensure strong representation in our workforce, and aligned policies and accountabilities. And externally, this is core to our client-driven approach, delivering products and services that meet the needs of our diverse clients and communities.

Building on that longstanding work, and in order to ensure everyone has access to the tools and resources needed to build wealth, we are focused on several key areas: connecting diverse people and communities to good jobs; ensuring adequate access to healthcare; providing access to capital to grow small businesses; and building a solid base of affordable housing.

This work is fundamental to how we run our company, support our teammates and deliver for clients. It spans the company – from our $15 billion commitment to affordable homeownership to our ongoing work to advance small businesses through $2 billion invested with Community Development Financial Institutions, to our $1.25 billion five-year commitment of which we have already directed more than $450 million of through financing and philanthropy. We do this because it’s the right thing to do and we know we have a role to play to be part of the solution to drive progress.

We also recognize that we share collectively in the responsibility to do more, so we continue to focus on working collaboratively across sectors to advance opportunities that will create real impact in the lives of individuals and for the communities we serve, using the past to inform our perspective and understanding as we tackle systemic issues embedded within our communities to be a company of opportunity for all. We continue to measure and share our progress around all that we are doing to advance racial equality and economic opportunity with our clients, communities and stakeholders through various channels, including our most recent annual report.

How critical is it for Bank of America to build a diverse and inclusive workforce to mirror the diversity of its clients and the communities it serves?

We understand the role we play in influencing and driving progress around diversity, inclusion, racial equality and economic opportunity in financial services, the private sector and the communities where we live and work. That’s why we continue taking meaningful steps to drive diverse representation at all levels of the company and are building a culture where our employees feel comfortable being who they are and bringing their whole selves to work with equal access to opportunities regardless of their differences. It’s the right thing to do, and we think it’s good for business. Companies that focus on creating a strong culture of diversity and inclusion reap several benefits including greater innovation, stronger employee engagement and productivity, and a positive impact on their bottom line.

Our Board of Directors, its committees and our CEO play a key role in the oversight of our culture, expecting management to be accountable for ethical and professional conduct and our commitment to being a great place to work. Each management team member has actionoriented diversity goals which are subject to our quarterly business review process, talent planning and scorecards reviewed by the Board. Management team members cascade goals to support commitment and accountability across the company, and drive an inclusive work environment. In addition, our Global Diversity & Inclusion Council (GDIC) also promotes diversity goal setting, which is embedded in our performance management process and occurs at all levels of the organization.

More importantly, our focus on the representation of our people is mirrored in the clients and communities we serve. Our management team is now 55 percent diverse, including seven women, two Black/African American, two Asian and one Hispanic-Latino leaders. At the end of 2021, our company remained one of only nine S&P 100 companies with six or more women on the Board. All told, our management team going forward is more diverse of gender, race and ethnicity than ever before in our history.

We also continue to exceed industry benchmarks for our diverse workforce and inclusive culture. Our workforce is 50 percent women and 49 percent people of color, and we have worked hard to narrow the gaps at our leadership levels across the company. We hold ourselves accountable for increasing diverse representation by disclosing our employment metrics, measuring progress across top management levels, helping ensure managers are responsible for driving advancement on their teams, and building a robust pipeline of emerging talent through recruitment and partnerships at campuses across the world.

You joined Bank of America more than 20 years. What has made the experience and the company so special for you?

It has been exceptionally gratifying to work for a company that has consistently delivered for our shareholders, our employees and our communities alike. Importantly, we’ve been able to do that in good times as well as in times of hardship and crisis – when our clients and communities needed us most. Building a company out of the financial crisis that has leveraged its 200,000-employee base to connect and deliver for its constituencies, all while delivering an adequate return for its shareholders, is something I consider very special. We have demonstrated that a purpose-led, value-driven company can grow not only consistently, but also responsibly – and that’s tremendously rewarding.

What advice do you offer to young people entering the workforce and beginning their careers?

Firstly, I encourage young people entering the workforce to continuously ask “why” in everything they do to really understand the goal of the exercise and to become goal-oriented versus task-oriented. Secondly, particularly in companies as large as ours, you need to develop empathy. At Bank of America, for example, we have a diverse group of employees and clients with varying degrees of beliefs and understandings. Having empathy improves communication and strengthens relationships to allow you to connect more successfully. And thirdly, before making any important decision, always try to prove yourself wrong. By questioning and re-questioning your assumptions, your data, your processes, and ultimately your judgments, you can significantly increase the likelihood you are making the right decision and get the best outcomes.•

“More importantly, our focus on the representation of our people is mirrored in the clients and communities we serve. Our management team is now 55 percent diverse, including seven women, two Black/African American, two Asian and one Hispanic-Latino leaders. At the end of 2021, our company remained one of only nine S&P 100 companies with six or more women on the Board.”