There are other dimensions of biotechnology. If you think of biotechnology like the Internet, it's not a category - it's an infrastructure that can be deployed to sustain or disrupt. In health care, the most complex problems at the high end have to be dealt with in a problem-solving mode by the best, most experienced physicians you can find.

How can you make sense of the future when you only have data about the past?

If you just look at the data, you are led to believe that things are getting better, rather than worse. That's why the fall is really precipitous, once you hit the ceiling.

At the beginning of almost every industry, the available products and services are so expensive to own and complicated to use that only people with a lot of money and a lot of skill have access to them. A disruptive technology is an innovation that simplifies the product and makes it so affordable that a whole new population of people can now have one and use it at the beginning for simple applications, and then it improves to the point that it makes the old technology obsolete.

This is one of the innovator’s dilemmas: Blindly following the maxim that good managers should keep close to their customers can sometimes be a fatal mistake.

Quite often startups were first out of the gate with a sustaining technology. But somehow the leaders got the technology and stayed atop their industries. Sometimes they acquired the startup; sometimes they just developed the technology as a follower and used their muscle and mass to win. But they always won.

And if your attitude is that only smarter people have something to teach you, your learning opportunities will be very limited. ... When we see people acting in an abusive, arrogant, or demeaning manner toward others, their behavior almost always is a symptom of their lack of self-esteem. They need to put someone else down to feel good about themselves.