Examined Lives: Stories from the Great Challenges

As medicine and science enter the era of quantified self, a parallel movement is growing: A reflexive self, as revealed in the stories we tell to others.

In medicine, listening to stories may help clinicians better understand patient symptoms and needs, thereby giving them better clues as to how to treat. Narrative medicine encourages a holistic view, a “whole-patient” treatment that balances the disease-specific, specialty-centric mode of medicine that prevails in the U.S., and the formulaic task of updating electronic medical records that can erode the personal, intimate aspect of provider-patient relationships.

In science, narrative helps explain a language of details and theory that can seem all too arcane and abstract to a lay audience — even though they’re constructed in an effort to make sense of our existence and our universe.

An Aid to Learning and Healing

“Healthcare’s challenges will be met through relationships and through story, connecting all through the power of narrative,” says Margaret Cary, a physician who teaches personal essay and narrative medicine at Georgetown University School of Medicine.

Writing things down may be helpful for providers, she says. “What I find is that when my physician students write stories they have a way to process what previously might not have made sense to them,” she says. “When you write and tell a story, current neuroscience says that it uses more parts of your brain than reading or listening.”

And when it comes to patients, Cary says, “There’s a healing process to talk about illness. We want to be connected; we want to be heard. I know a woman who volunteers at an organization for Latina women who have cancer.  A third of her support group is terminal. And the reason they’re there is they want to share their stories with others.

“It turns out that in terms of keeping us happy and to be satisfied, doing things for others works better than just going and buying something for ourselves.”

A Gathering to Explore Storytelling in Science

In the end, stories help us integrate the intricate workings of the physical world with our humanity. How do we apply these powers to the bigger picture, to understanding how science and medicine affect groups and systems?

On the afternoon of Friday, April 19th, TEDMED Delegates will explore the power of storytelling during the first Great Challenges Day at George Washington University. Delegates will explore how personal, anecdotal views can help us all come to grips with some of health and medicine’s most complex issues, revealing the holistic view needed to grapple with these widespread, systemic problems.

To preview the Day and move forward with our own conversations about the Challenges, TEDMED is beginning a new blog feature, Examined Lives: Stories from the Great Challenges. We’ll talk to patients, practitioners and those who have been directly affected by issues ranging from caregiving and sleep deprivation, to preventing childhood obesity and controlling medical costs.

Click here for more information on Great Challenges Day, and please watch for Examined Lives.

What will a lateral thinker be when he grows up?

This is a guest post by Sandeep Kishore, a post-doctoral fellow at Harvard Medical School and TEDMED 2012 speaker.

Recently, I’ve been struggling on how to explain to other folks what it is that I do – or what it is that I am attempting to do.

I still don’t really know.

But I have found some clues recently via a Harvard University website called the Catalyst. It effectively catalogues all people at 17 schools and hospitals associated with Harvard University (from those studying anthropology to appendicitis, from molecules to masses), ‘catalyzes’ new connections, and provides pilot grants to help incent people to work on problems together.

 

What I like most is that the translation agenda via this website. It provides a useful frame for PhD basic scientists to communicate with MD clinicians and with the policy/public health community.

In the university community, and certainly in training, there are rifts between bench scientists and the clinical docs. Now add in the fact that the biological/pathogen model is old news, mental models are shifting and there are new behavioral/social issues that add to the canonical biomedical approaches, and now we have a real and urgent need for translation.

The Catalyst profiles a translation agenda labeled T1 thru T4:

T1: Basic Scientific Discovery to Clinical Insights

T2: Clinical Insights to Implications for Practice

T3: Implications for Practice to Implications for Population Health

T4: Implications for Population Health to Improved Global Health

This provides a useful continuum and includes tools to broker linkages along the way. And the curation of resources begins the moment any staff member joins Harvard University. In a moment, your publications, your topic areas, people who publish/think like you and even people who physically sit next to you are highlighted. The website is designed to foster creativity and collaboration – and is blind to exactly where those insights might come from. Anyone, from student to president, can participate and link-up.

Best of all, the site is public so that anyone else can view, learn and engage. This is the sort of multidisciplinary effort that we will need for complex health challenges –and I’m delighted that it’s housed at a major university with access to ideas, young blood and energy.

I connected with Dr. Lee Nadler and Dr. Elliott Antman, founders and leaders of the platform, to learn more on the origins and functions of the Harvard Catalyst. I was looking for practical outputs of this network. They relayed one challenge where engineers and researchers were searching for practical applications of next-generation imaging techniques; and one in which radiologists were searching for, well, next generation imaging modalities. Both groups were unintentionally boxed in their professional silos. The Harvard Catalyst challenged the community – write in 250 words, one big idea to bridge the gap, identify how a biological/medical problem could be solved by imaging techniques.

They expected maybe 30 submissions across the 12,000 people unified on the platform. They received 500.

Next, they arranged a poster session where 150 people presented their idea over three evenings. New ideas including novel ways to image islet cells of the pancreas emerged. Success: People not aware of each other’s existence came together; new teams were formed and there was even a bit of funding for pilot grants to try out the best, most promising ideas. As Drs. Nadler and Antman say, their vision is not to bring institutions together; it is to bring people together.

Sandeep Kishore at TEDMED 2012

TEDMED and a network I co-founded, the Young Professionals Chronic Disease Network (YP-CDN) provide some examples of the sort of ‘safe spaces’ for incubation, networking, curation and then translation of ideas to action. Particularly for the way we train the next generation of university students. These initiatives are exciting in that they provide a new nidus for meet ups that foster imagination, innovation and inspiration and that move us beyond hardened paradigms. This is critical for this generation, and even more so for the next.

It all reminds me of the quote by the playwright Edith Wharton relayed to me by an old mentor: “There are two ways of spreading light: to be the candle or the mirror that reflects it.”

These incubators serve as mirrors that help focus, amplify and merge our individual lights of inspiration. This is a neglected, but vital function, for translators. Maybe I’ll grow up to be a mirror?

Live event Thursday: What can adults do to reduce childhood obesity?

This week at TEDMED, we’ll be focusing on a Great Challenge with perhaps the biggest impact on future health: reducing childhood obesity.  Some 17 percent – 12.5 million – of kids in the U.S. are obese. How did we get here, and what can we do about it? Watch Judith Salerno and John Hoffman talk about “The Weight of the Nation” at TEDMED 2012 – and join our live online event this Thursday at 1 pm ET.  Moderating the discussion is Sally Squires, former Washington Post nutrition columnist and Director of Health and Wellness for Powell Tate. Visit TEDMED’s Google Plus page for details.  Ask questions of our group of health leaders on the topic – they may answer them on air.

Live online event today: Whole-patient care

The number of medical specialists (and specialties) continues to grow while the number of primary care physicians continues to shrink.

In the process, the goal of fitting all these specialties together for effective whole-patient care becomes ever more elusive. How can we treat the whole patient rather than the disease?

Join our Great Challenge team of health leaders for a live event today from 1-2 PM EST to discuss whole-patient care. Ask questions on Twitter @TEDMED #greatchallenges – the group will answer selected questions on air. John Nosta, EVP of Ogilvy CommonHealth, will moderate the chat.

Click here to access TEDMED’s Google Plus event page.

Great Challenges Live Event: Can we make prevention popular and profitable?

America spends $2 trillion a year on healthcare — mostly treating people after they become sick. How can we unlock prevention as a trillion-dollar business in America so we spend less on “sick care” and get Americans to “buy” healthy lifestyles?

Join TEDMED on Thursday, January 17th for an informal, moderated discussion with multi-disciplinary thought leaders who will share their views and respond to audience questions on this Great Challenge.  Contribute your thoughts and ask questions in real-time via Twitter – use the hashtag #greatchallenges — or via TEDMED’s Google Plus Event Page, where you can also view the event.

Implementing the ACA: What will 2013 bring?

2013 is the year when ACA implementation kicks into full gear.  What’s it going to take to push it forward? Will its goals be achieved?  And what will healthcare look like when the dust settles?

Charlie Baker, Entrepreneur in Residence at General Catalyst Partners and former CEO of Harvard Pilgrim Health Care; Jeff Goldsmith, one of the nation’s foremost health industry analysts; and Alexandra Drane, Founder, Chief Visionary Officer and Chair of the Board of Eliza Corporation (and TEDMED 2010 speaker), sat down to talk over what’s in store for the coming year.

To give you a hint of where this goes, we’ll just quote one of the first comments, from Goldsmith: “The people who framed this bill could not possibly have made it more complicated.”

Among their topics:

* Are projected ACA costs accurate and if not, how will can employers, patients and the government afford it?

* What are some hidden factors contributing to skyrocketing healthcare costs, and will the situation improve?

“…We’ve been paying for people to react.  We’ve been paying for visits that are initiated by a complaint.  We’ve been paying for interventions.  We’ve been paying for hospital admissions.  We’ve been paying for procedures.  What we really need to be paying for is relationships.  And those relationships differ depending on the patients’ needs.  There’s some people that really don’t need much of a relationship but need access, need questions answered, need problems solved…” - Jeff Goldsmith

* Are states ready for health exchanges?  Is the Fed?

“There’s a lot of money being spent by the private sector right now to put these private exchanges up and I think they have the potential to be really game changing on this…” - Charlie Baker

* Can physician groups and ACOs compete with large hospitals by offering advanced care?

* How would simplified payment systems improve productivity and cut costs, and ameliorate the effects of the predicted upcoming primary physician shortage?

* Will exchanges give patients a truly consumer-driven marketplace, with increased choices and potential cost savings?

* How is the provider community responding to all of the uncertainty? Is anyone demonstrating the use of decisions support tools, alternative incentive structures and/or marketing initiatives well?  What are they doing?

Download the full discussion here.

 

 

How can we make prevention profitable?

America spends $2 trillion a year on healthcare — mostly treating people after they become sick. How can we unlock prevention as a trillion-dollar business in America so we spend less on “sick care” and get Americans to “buy” healthy lifestyles?

That’s what we’ll be discussing Thursday at our next Great Challenges Google hangout. What questions would you like to see our panelists address? Reply below, on our Facebook page or via Twitter.

Great Challenges live events double-header: Teams of experts discuss medical innovation, preventing errors in healthcare

TEDMED held two live events yesterday with team leaders from the Great Challenges program.

The first, achieving medical innovation, centered on affordability, oft cited as a barrier to getting new products and services to market, particularly technology.  Participants quickly countered the notion by pointing out how often innovation is introduced to save money — and how small, cost-efficient steps can make a big difference.  Watch the group here:

TEDMED Great Challenges: Achieving More Medical Innovation, More Affordably

For more on this event, see the Twitter recap by MedCityNews, “TEDMED innovation panel: We’re on the verge of a patient engagement explosion.”

A second group met later in the afternoon to talk out the more sobering topic of medical errors. Here, too, the topic of where and how to innovate, and particularly when technology helps or harms, figured large in the conversation, as well as introducing novel collaboration.  In this case, however, the group agreed that the system must first cure itself before asking further involvement from patients in their own care.

TEDMED Great Challenges: Reducing Medical Errors

John Nosta, EVP of Ogilvy CommonHealth, moderated the events.  The program is sponsored by Robert Wood Johnson Foundation.  See TEDMED’s Google Plus page for upcoming Hangouts, which will be held almost ever week through February.

TEDMED Live Goes Global; Applications Now Accepted

Registration is now open for TEDMED Live, a free simulcast of TEDMED 2013 to qualified organizations. New this year:
  • All sessions will be broadcast live April 16th-19th from the Kennedy Center and made available on-demand thereafter through Sunday, April 21st for maximum scheduling flexibility.
  • The simulcast will be extended to include dozens of international locations.
  • Affiliates can video-record speakers and submit the talks to TEDMED.  Appropriate talks will be posted at TEDMED.com and those delivering the best of these may be invited as speakers to the Opera House stage of the Kennedy Center during TEDMED 2014.
  • Those who organize a TEDMED Live event for at least one day using an auditorium-style format will also have on-demand access to all TEDMED sessions from individual laptops and tablets.
  • A limited number of Delegate seats at the Kennedy Center are available to TEDMED Live affiliates at a courtesy rate.
Visit www.tedmed.com/live for more information and to apply.

TEDMED Will Hold First-Ever Great Challenges Day at GWU this April

On the afternoon of Friday, November 19th, on the George Washington University campus in Washington, DC, TEDMED will host its first-ever Great Challenges Day, a multi-disciplinary gathering of some 500 TEDMED Delegates including medical professionals, technology experts, policymakers, non-profit leaders, big business leaders and academics.

It’s the culmination of the first cycle of TEDMED’s first Great Challenges Program: A multi-disciplinary, crowd-sourced community effort to understand some of the most complex and persistent problems in health and medicine. Since April 2012, the TEDMED community has explored issues like the obesity crisis, medical errors and medical costs via social media, online at TEDMED.com, and via live online events.

The Science of Storytelling

Using tools from the emerging discipline of medical and scientific storytelling, participants will collaborate to better understand — and to better communicate — the complexities of some of health and medicine’s most complex and pressing challenges.

You must be a TEDMED 2013 Delegate to attend the Great Challenges Day. Click here for details on the Day, and here to apply for an invitation to TEDMED 2013.