What happens when a neuroscientist follows his curiosity from the brain to the soil, and then to the stars? In this episode of Leap Together, Zach Gobst sits down with Dr. Joshua Ortiz-Guzman, a gene therapy engineer and developmental neuroscientist turned clinical research leader, industrial biotechnologist, and soil health innovator. Joshua's work spans an unusually wide range: building clinical research capacity in underserved El Paso, Texas; developing microbial biochar technologies that restore degraded soils; banking stem cells to rigorously track regenerative medicine outcomes; and orienting all of it toward a long-term vision of human longevity and space exploration.

This episode explores how environmental health and human health are deeply interconnected, and why that connection is chronically underappreciated in clinical research. Joshua shares how his PhD on brain-driven food intake led him down a rabbit hole from farm-to-table agriculture to emerging environmental contaminants like PFAS ("forever chemicals"), and why he believes the clinical research community can't fully understand drug outcomes without accounting for the environments patients live in.

He also reflects candidly on the challenges of building a research program from scratch in El Paso, a predominantly Spanish-speaking, medically underserved region where providers are overstretched, community trust requires intentional outreach, and groups like the Medical Center of the Americas are making real strides through “promotoras” led education. Joshua's journey from academic idealism to real-world business acumen, from soil pilots in Chihuahua and Colombia with Aurum Tech to a Florida-based stem cell bank called Prodigy Cells, is a rare example of evidence-first rigor applied consistently across human health and environmental systems.

What does it actually take for a high-performing clinical practice to step into research for the first time? In this episode, Zach Gobst sits down with Dr. John Mandeville, a leading oculoplastic surgeon at Ophthalmic Consultants of Boston, to trace his unexpected path from bench science and surgical practice back to clinical research and what he's learned in his first year running studies.

Dr. Mandeville shares how a career spent treating Thyroid Eye Disease (TED) led him to seek out new treatment options when surgical approaches alone weren't enough, and how that curiosity brought him from enrolling a single patient to running eight or nine clinical trials in just twelve months. He reflects honestly on the steep regulatory learning curve, the importance of building the right team, the challenge of managing patient expectations and motivations, and what it really costs, financially and personally, to build a research program inside a busy private practice.

His perspective on patient recruitment is especially candid: from understanding why some patients are eager to enroll, to knowing when to talk someone out of a trial entirely, Dr. Mandeville brings a grounded, empathetic lens to what is often treated as a purely logistical problem.

What happens when a pediatric oncologist who has sat at the bedside of children with cancer decides the best way to help more patients is to leave the clinic entirely? In this episode, Zach Gobst sits down with Dr. Kristiyana Kaneva, a board-certified pediatric hematologist, oncologist, and neuro-oncologist, now Senior Clinical Director of Oncology Early Development at AbbVie, to explore what it really takes to bridge the gap between the bench and the patient.

Dr. Kaneva reflects on her training at Children's Hospital Los Angeles, the weight of caring for critically ill children, and the early mentor who first introduced her to the world of precision medicine and pediatric brain tumors. She shares how that spark led her to Tempus AI, where she led an end-to-end team to bring a minimal residual disease (MRD) test for colorectal cancer from concept to commercial launch and what it felt like to see that test making a real difference in the clinic.

Now at AbbVie, Dr. Kaneva discusses the work of oncology early clinical development: shepherding novel molecules through IND submissions and first-in-human Phase 1 trials. She makes the case for why pediatric patients can't be an afterthought in drug development, how FDA regulatory guidance is beginning to close that gap, and why the next generation of in vivo CAR T therapies could transform access for patients around the world.

In this episode, we cover:

• What drew Dr. Kaneva to pediatric oncology as a college student and why she never changed course
• The emotional realities of training at one of the country's busiest pediatric cancer centers
• How precision medicine and a pioneering mentor at CHLA redirected her career toward diagnostics and industry
• Leading the development and commercial launch of an MRD test for colorectal cancer at Tempus AI
• What oncology early clinical development looks like at AbbVie from IND applications to first-in-human trials
• Why pediatric drug development has historically lagged and how the field is slowly catching up
• The promise of off-the-shelf in vivo CAR T therapies and what they could mean for global patient access

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