This presentation will discuss the world's first brain computer interface (BCI) implant in humans using the natural highways of the brain - your blood vessels! From the first "thought-controlled" hands-free tweet by a patient with ALS, to the first U.S. human patient implant of a permanent BCI, conducted at Mount Sinai Health System in July 2022, this talk will discuss what it means for patients with paralysis, and the future of communication. BCI technology is now scalable, with a new approach that does not require open-brain surgery. Will scalable BCI technology be as common as LASIK surgery in the future? By 2050, will the majority of people have a permanent BCI implant, to communicate with their digital devices hands-free?