In this episode, Dr. Zak Kohane shares his journey into AI and medicine, reflecting on early influences from science fiction authors and programming experiences in his youth. He discusses his academic path, moving from programming and machine instruction to medical school, driven partly by practical advice and personal ambition. Kohane highlights his realization during medical school that medicine was not as scientifically advanced as he expected, motivating his interest in improving medical decision-making through AI. He recalls his time at MIT, contrasting the intellectual freedom there with today’s academic environment, and reflects on the impact of large language models in medicine, emphasizing their real-world applications and potential to transform medical practice. Kohane also discusses the importance of mentorship, his approach to nurturing talent, and the role of his department at Harvard in advancing the field of biomedical informatics. Finally, he shares insights on the NEJM AI journal, its objectives, and the challenges and opportunities in medical AI today.