Ted Shortliffe built MYCIN at Stanford in the 1970s, one of the first medical AI systems ever deployed in a clinical setting. Five decades later, he joins Steve and Leon to examine what has persisted in clinical decision support — above all, the demand for explainability — what has changed (computational power finally caught up to the ideas), and what the field may have lost along the way. The conversation includes a direct response to Bob Wachter's claim from S1E24 that AI in healthcare decision support was "too hard a problem to start with," and a case for why structured knowledge representation deserves a second look in the age of LLMs. For anyone tracing the arc of medical AI history, this episode is a rare primary source.

AI in drug discovery has been long on promise and short on delivery. Matt Truppo, Global Head of Research Platforms and Computational R&D at Sanofi, presents a different picture. His team used AI to identify 10+ novel drug targets in 12 months, screen 30 million target combinations in days, and produce AI-designed compounds with 75% synthesizability. But Truppo is equally candid about the gaps: data integration, explainability, and change management remain real barriers. In Part 1 of this two-part conversation, hosts Steve Labkoff and Leon Rozenblit explore what happens when AI moves past pilot projects into core pharmaceutical science.

Every five episodes, Steve and Leon step back to examine what picture forms when you put their guest conversations side by side. This time, five guests from completely different healthcare domains -- data quality, clinical trials, medical translation, patient data, participatory medicine -- independently converged on the same conclusion: the AI works; the infrastructure around it doesn't yet. From Charlie Harp's data quality metrics to Adam Blum's 60-to-90% scaffolding story to Amy Price's reframing of healthcare AI as "unfinished, not broken," Block 4 reveals what industry maturation actually looks like -- not a breakthrough, but a quiet shift in what the conversation is about.