Zerhouni saved his most emphatic point for last: dream big. The metaphor of the 'dream box' was simple but effective — you can't fit a large box (a full life) into a small box (limited ambitions). If your dreams are too small, they will constrain everything that follows. This carried particular authority coming from someone whose own dream box had been enormous and improbable. Zerhouni had immigrated from Algeria with almost nothing — no money, no connections, no family in America — and risen to lead the NIH, the largest biomedical research institution in the world. His journey from a $300 immigrant to the director of an agency with a $28 billion budget was itself proof that the dream box can be as large as you dare to make it. He explicitly exempted two things from his 50/50 rules: integrity ('Your integrity has to be constant — 100 percent') and love ('In affairs of love, I don't think you should play the 50/50 rule. That would be deadly.'). Dreams should be expansive; integrity and love should be absolute.