Jake Adler is the founder of Pilgrim, a defense biotech company building next-generation military medicine and biosurveillance systems. The conversation spans trauma care, bioweapons, synthetic biology, sleep optimization, and the future of human performance—all grounded in Jake’s hands-on lab work and unconventional philosophy of reducing human friction to maximize output.
The future battlefield demands better medical tools
Modern warfare is shifting from counterinsurgency (Afghanistan, Iraq) to large-scale combat operations where warfighters are dispersed across vast, contested spaces with limited access to medics or evacuation.
This means injured soldiers may be on their own for days, making rapid hemorrhage control and tissue regeneration critical—not just for survival but for returning to duty.
The definition of “casualty” is changing: if a soldier can’t pick up their gun, they’re a casualty, regardless of whether they’re alive.
Tourniquets haven’t meaningfully evolved in 2,500 years
Tourniquets were first used by Alexander the Great and remain largely unchanged.
The current standard is the CAT tourniquet (Gen 7), which took 5–6 years to update from Gen 6 with only minor improvements (a red tab and a manual spinner).
Tourniquets can only be applied to limbs, not junctional areas like the groin or armpits, and the abdomen is too compressible for effective pressure.
Leaving a tourniquet on beyond 6–12 hours can cause amputation or death due to inflammatory cascades; in Ukraine and Israel, soldiers have had them on for days.
Many warfighters aren’t properly trained—some have died from hemorrhage with a tourniquet still in their pocket.
The messy history of hemostatic agents
Zeolite (Quikclot): Discovered serendipitously by Frank Hersy (Zmedica), who used it to stop shaving cuts. It works by concentrating coagulation factors but is exothermic—causing second- to third-degree burns in hundreds or thousands of cases. Despite this, it saved lives during the early Global War on Terror when nothing else worked.
HemCon (chitosan-based): Made from crushed shellfish shells embedded in gauze. Less effective than Quikclot and unusable for those with shellfish allergies. Backed by the Army, it was positioned against Quikclot in a rivalry reminiscent of Edison vs. Westinghouse.
Teleflex acquired Zmedica for ~$500M in 2020 and now dominates the hemostatic market but has stagnated—firing business development staff and not showing up at major conferences.
Between 2017 and 2021, the DoD procured 650,000 IFAKs (individual first aid kits), each containing at least one hemostatic agent.
Kingsfoil: Pilgrim’s next-generation hemostatic
Jake’s first product, Kingsfoil, started as a patch but evolved to accommodate gauze-based delivery because the Army is trained on gauze—introducing a gel would require retraining the entire infantry, which is a non-starter.
The product aims not just to stop bleeding but to regenerate tissue, enabling faster return to duty in prolonged combat scenarios.
Testing involves cutting the femoral artery in pigs (swine models are physiologically close to humans); Jake has also self-tested earlier versions.
Electronic tourniquets and their limitations
Jake showed an Israeli-made electronic tourniquet that has a timer but no sensors for pressure, blood oxygenation, or circulation monitoring—making it potentially dangerous.
In mass casualty events, tracking time across thousands of tourniquets is impractical without a centralized system.
Medical device development pathways
Pilgrim focuses on Class 2 medical devices (like condoms, contact lenses, CGMs), avoiding the $900M–$3B cost of drug development (NDA pathway).
510(k): Fast clearance based on a predicate device (~$5K–$30K); relies on a competitor having already gone through De Novo.
De Novo: For novel devices with no predicate; more expensive and time-consuming.
Pilgrim’s core thesis is translating languishing academic research into fielded products—bridging the gap between lab concepts and real-world deployment.
Biosurveillance: BioWatch is broken
BioWatch (launched 2003): 3,000 sensors across the U.S. that pull air through filters. State/municipal workers must drive 4 hours to each sensor daily, swab it, drive back, and run PCR—results take ~72 hours.
Sensors are frequently unplugged by people who want the outlets for laptops and phones; there’s nothing in contracts requiring locked outlets.
A DHS Inspector General report found that 34 of 35 jurisdictions don’t meaningfully collect data.
BioWatch only detects 6 of 14 known threats—by design. DHS policy is to only detect threats they already have counters for.
Two modernization attempts (Gen 3 and Biological Detection 21) failed to define requirements or find procurable technology.
The DHS CWMD office was recently dissolved under DOGE; BioWatch is being moved to CISA (Cybersecurity and Infrastructure Security Agency), a cyber-focused agency with no biological expertise.
Argus: Real-time autonomous biosurveillance
Jake built Argus, a near-real-time biosurveillance platform using a Dyson fan impeller as an intake mechanism to pull airborne viral particulates.
Instead of PCR (which requires prior knowledge of the threat and specific primers), Argus uses nanopore sequencing—feeding DNA/RNA strands through a protein pore and detecting changes in ionic current to identify bases in real time.
This enables detection of novel or emerging threats without prior sequencing.
Jake plans to do a challenge study on himself: infecting himself with H1N1 (or common cold), then potentially doing gain-of-function mutations, to test whether Argus can detect them.
Long-term vision: a network of Argus sensors in airports, farms, and critical infrastructure, combined with wastewater surveillance and nasal swabs, creating a real-time “plague map.”
The CDC’s limited surveillance
The CDC’s Traveler Genomic Surveillance Program operates in only 9 of 5,412 U.S. public airports (JFK, LAX, SFO, etc.), pulling wastewater off planes to test for pathogens.
This misses people who don’t use plane bathrooms and provides no real-time detection.
COVID caused a summer surge detected through this program, but coverage is minimal.
Bioweapons are easier to make than people think
Jake describes bioweapons as the “poor man’s nuke”—if you know your way around a lab and have worked with vectors (AAV, lipid nanoparticles, polymeric nanoparticles), it’s straightforward to encapsulate a purified virus.
A terrorist could walk into JFK with a tube of Ebola and spread it on bathroom handles; attribution would be nearly impossible with current PCR-based systems.
Procurement is shockingly easy: Jake ordered anthrax lethal factor with no certification—just a phone call verifying his LinkedIn and claimed government work. It arrived via standard shipping.
Encapsulating such proteins in polymeric nanoparticles (well-documented on PubMed) effectively creates a bioweapon—no LLM or AGI needed.
The 2001 anthrax attacks were an inside job
After 9/11, letters containing anthrax powder were sent to journalists and politicians; 5 people died, 21 were injured.
The spores were traced to USAMRIID (U.S. Army Institute for Infectious Diseases) at Fort Detrick.
The attacker was an Army officer leading anthrax vaccine development who proliferated the attack to create demand for his vaccine and drive appropriations.
Historical bioweapons programs
Japan’s Unit 731 (WWII): Used “Oogi bombs”—ceramic bombs coated with virus-carrying fruit flies dropped on cities. Flies would infect rats, which would spread disease through populations (similar to Black Plague dynamics). Researchers were granted immunity after the war in exchange for sharing data.
Smallpox: After eradication, two samples were kept—one at the CDC (U.S.) and one at the Vector Institute (Russia). The U.S. is not confident Russia hasn’t used its sample. The WHO reportedly dumped a massive stockpile of variola vaccines to avoid refrigeration costs. The U.S. now maintains a policy of one vaccine dose per citizen.
Lyme disease theory: A researcher at USAMRIID was allegedly studying tick-borne pathogens as biological weapons, paralleling Unit 731’s work.
Nerve agents and antidotes
Paraxon (in Jake’s lab) is an organophosphate compound ~70% as potent as sarin. It inhibits acetylcholinesterase, causing acetylcholine to accumulate uncontrollably—leading to salivation, lacrimation, urination, defecation, gastrointestinal distress, emesis, seizures, and death.
Current antidotes (2-PAM, atropine) are Cold War-era therapeutics, not prophylaxes—they only work post-exposure and require auto-injectors because victims can’t manually inject while seizing.
MOPP suits are bulky, have terrible thermal management, and people have been forced to wear them for days during training.
Jake was developing a next-generation antidote using polymeric nanoparticles and nano-electroporation—shocking cell membranes to create pores for near-95% efficient delivery (vs. 5–10% for lipid nanoparticles).
COVID’s impact and origins
COVID cost the U.S. $16 trillion in GDP impact (twice the Global War of Terror’s $8 trillion over 20 years vs. 2–3 years).
U.S. casualties are estimated at ~1.23–1.3 million (likely undercounted); equivalent to 412 9/11 attacks.
The USS Theodore Roosevelt carrier was sidelined for 10 weeks after 1,000 sailors contracted COVID—10% of naval air fighting capability lost to a biological agent with no direct confrontation.
Jake attributes the origin to the Wuhan laboratory.
Sleep optimization and reducing human needs
Jake has experimented with polyphasic sleep but now sleeps when it makes sense—no fixed schedule.
For longer sleeps (6.5+ hours), he takes GABA, 200 micrograms of melatonin (vs. the 5–10 mg commonly sold, which is ~100x what the pineal gland produces and causes next-day drowsiness), and glycine.
He sources low-dose melatonin from Life Extension; Thorne and Momentous are also recommended supplement brands.
His broader philosophy: reduce human needs (social interaction, food, sleep) to minimize cognitive load and maximize momentum—“95% robot.”
Self-experimentation and human performance
Jake ran a marathon with no training using an exoskeleton (one horsepower, running at 15–20% power due to battery limitations—he carried five batteries) and BPC-157 (body protection compound), a peptide that supports angiogenesis and reduces inflammation.
He injected BPC-157 into his calves at 4 AM and felt no pain during the run except in his feet.
He’s used amphetamines and modafinil regularly in the past but exhausted his dopaminergic system—now caffeine makes him lethargic, so he’s mostly cold turkey.
Blood supply and synthetic blood
The military faces constant blood shortages; they carry crystalloids (saline) instead of blood because blood requires refrigeration.
There’s been exploration of extracting blood from KIA soldiers for transfusion to living wounded.
Veterinary synthetic blood exists (Oxyglobin/hemoglobin-based oxygen carriers using expired hemoglobin in polymer nanoparticles).
Blood conversion research focuses on using enzymes to strip antigens from red blood cell surfaces, converting any blood type to universal donor (O negative).
Gene editing could theoretically make everyone type AB (universal acceptor), which is preferable to O negative (universal donor but can only receive O negative).
Synthetic blood for humans is close but held back by FDA processes and religious objections (Jehovah’s Witnesses refuse non-human-origin blood).
Liquid diet and reducing decision fatigue
Jake is interested in a liquid diet (e.g., Soylent) to reduce the body’s energy expenditure on digestion and eliminate decision-making around food.
His broader framework: treat the phone like a dictionary (only books, no social media on mobile), work across multiple disciplines in the lab to maintain dopamine, and keep 3D printers and reactions running while he sleeps.
Video games and systems thinking
Jake was obsessive about Call of Duty (MLG competitive), Minecraft, and Factorio growing up.
After a grueling sprint building a nanoparticle nerve agent antidote (during which he flew his brother in from Poland to help with cell culture and synthesis), he binged Civilization for a day and a half as a mental reset.
Getting kicked out of a conference
During the nanoparticle sprint, Jake brought a vial of pink liquid (containing Rhodamine B dye) on a plane to a conference in Florida.
Two team members weren’t registered, and security noticed the vial. While being removed, a team member ran into the conference room and pitched the JPEO (Joint Program Executive Office) representative outside—Shark Tank style—with the general’s laptop on a garbage bin.
Building a biotech prime
Jake’s goal is to establish a “biotech prime”—a company that uses the DoD as a first market to rapidly develop and field medical devices in austere environments, then translate them to civilian use.
He cites Medtronic founder Earl Bakken (who built the first pacemaker from an electronic metronome circuit and implanted it in a baby during a blackout with no trials or clearance) and Frank Hersy as models of outsiders who transformed medicine.
The hardest thing he’s overcome is narrative creation—Pilgrim isn’t derivative of the Anduril/drone narrative; it’s a new myth around betting on the human over the machine in an era of autonomous warfare.
He sees the current moment as analogous to Anduril in 2005—early, misunderstood, with a long road ahead, but driven by divine providence and relentless execution.
