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Data Centers, Medicine, and AI Guilt
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Released: July 29, 2026

John Marshall
John Marshall, MD
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Would You Bet on a Clinical Trial?

[00:06:33] John Marshall, MD: John Marshall, Oncology Unscripted. Lots of stuff going on out there in our business world today. Our favorite thing that our crackpot staff found that's just new is that you can actually bet on the outcome of a clinical trial.

Are you worried about all of the promotion that's going on with these gambling apps that they're pushing to our kids and to young people—“We'll give you a free $100 with your first bet”—and that sort of thing? And you know that, if you're successful at your phone app betting, what they do is they actually stop you.

They tell you, you can't go there anymore because all they really want is people who aren't very good at it on their betting apps. And now you can bet on the outcome of a clinical trial. And I was thinking to myself, but isn't this a little like, you know, stock investment? Oh, this company just opened up a phase 3 study in colon cancer.

I'm gonna bet on that by investing in their stock and then see what happens. But, as was pointed out by the crackpot staff that we have—crackerjack staff, not crackpot staff, crackerjack staff—you know, there are rules around stock investment and the like, whereas you could just bet on a clinical trial outcome. So, be cautious there. What works in phase 2 doesn't always work in phase 3, so it's a pretty risky gamble that's out there.

But what I really wanted to focus on that's new out there is data centers. One thing that our entire country seems to be in agreement on is that we don't want them near us.

We've been coached that they might, on the positive side, produce jobs, but on the negative side, their energy sucks, and they need a lot of water and all of this stuff. And here in Washington, of course, we get a lot of “co-promotion yes, co-promotion no,” about whether we should be doing it or not doing it. But I was thinking about how, here in Washington, there are a ton of data centers out by Dulles, and then I use AI.

Do you use AI? I don't know if we should confess that out loud, but I use it to look medical stuff up. My Google search engine sometimes gives me that AI option up there. A great website called Open Evidence is basically a big AI-generating, re-reporting system that I find very, very useful.

And we've talked on this program before about whether we trust it or not and how to interpret what we get from it. But I'm suffering a little bit lately from AI guilt because, in order to have AI, I need data centers. It's like, in order to have a car, I need gas, and so I got to go drill for gas somewhere.

Is it the same issue? Every time I use AI, am I using energy? Am I creating more of the problem of needing more and more data centers and, therefore, consuming more and more energy? Look, I have a plug-in hybrid, for goodness' sake. I don't even really want to use gas. So, every time I go on, I'm thinking to myself, “Am I doing something a bit irresponsible?”

But in conjunction with that, we have everything from the FDA approving a new blood test looking for Alzheimer disease. Well, how did we figure that out? We figured that out from databases that then were analyzed using machine-learning AI to come up with the ability to measure some of these targets and some of these tests.

The University of California in San Diego has, in fact, put AI into practice. They've created—and I'll read this to make sure and get it right—the new Institute for Applied Health Intelligence at UCSD, and it's basically designed to connect AI research to clinical practice. So, we're gonna lean into it more and more.

Singapore, the nation, has put in a whole bunch of money, 2.5 billion, into preventive precision medicine, which is a major AI data kind of utilization to try and figure out who's at risk and who's not, so that you can overall save money and be more effective. And the NCI just announced that it reached a major milestone in precision medicine, with three-quarters of a million participants now in the integrated genomic and electronic health record database.

So, everyone is sure that collecting these huge amounts of data is gonna turn into some sort of return on investment. We're living it day in and day out with our AI utilization in every field. Let's face it: even our church is using AI to try and help communicate with members of our congregation, and I'm sure, in your life, you're using it, big and small, in your day-to-day life.

But what we need to make sure of, I think, is that we're also checking in on this data center issue. Is this going to be an environmental issue? Is this really a good thing, or is it ultimately somehow going to be used in a bad way for us or have a negative impact on our overall world? So, I would be curious to see what you guys think about AI guilt.

Do you have it or not? Or you don't care—you're just leaning in?

And I wanna close with one positive that I'm very proud of: at ASCO this year, we launched a new initiative that we're calling Kleos, K-L-E-O-S. if you look up Kleos in Greek, it actually is: what do you think about those who came before? Sort of that hero thing. But I think about it as all those patients who I've taken care of over the years who didn't make it, who lost their battle to cancer, and how they've influenced me going forward. So, they're my heroes in many ways.

But this clinical trial we are now launching across colorectal cancer—yes, using intelligence and AI and databases, so we're gonna collect those, but also beginning to intervene in an individualized way in earlier lines of therapy with colorectal cancer—is sort of disrupting the current clinical research profile and pattern so that we can drop costs; speed, uh, the go/no-go signals that everybody is looking for; and reduce the cost, uh, of drug development so more people can take advantage of our innovation and all that we are learning.

And I'm very pleased to be, uh, helping to lead that, uh, throughout the United States, and I know many of you out there are participating and are aware of that. So, I wanna thank you for your ongoing support and energy. But it, too, is dependent on AI and the collection of data.

So, share with me: is AI good or bad?

Are you having a little AI guilt like I'm having every time I look something up and the machine whirls a little bit, and I'm thinking, “Am I using energy out there at Dulles?” I don't know the right answer, but I'm probably not gonna stop right now 'cause this is Oncology Unscripted, and I'm John Marshall.

Thanks for joining.

​This transcript was generated by AI and lightly edited.