TEDMED Blog

A medical school in Cuba trains doctors to serve the world’s neediest

American journalist and Havana resident Gail Reed spoke at TEDMED 2014 about a Cuban medical school that trains doctors from low-income countries who pledge to serve communities like their own all over the world. She talked with TEDMED about the Latin American Medical School and its contributions to global health.

Why does this talk matter now? What impact do you hope it will have?

Ridden by Ebola today, other emerging infections tomorrow, and always by chronic diseases—our world needs strong health systems, staffed by well-trained and dedicated people. And their education must be the result of enlightened decisions from policymakers who put health first, learning from the likes of the Latin American Medical School to make these new health professionals the rule, not the exception. Now is the time for medical educators to make the changes needed to give us the kind of physicians we need. And to bring the profession into the movement for universal health care, bringing doctors to the forefront with other health workers. To walk the walk.

Gail Reed at TEDMED 2014

Gail Reed at TEDMED 2014 Photo: TEDMED/Sandy Huffaker

I hope that people seeing the talk will be inspired to act to support the Latin American Medical School graduates through our organization, MEDICC. I hope policymakers will take the School’s courageous experiment to heart, and then take another look at their budgets and find more for health and medical school scholarships; and that governments will find a way to employ these new doctors in the public health sector, in places where they are most needed. I hope the graduates will never ever wonder about their importance to global health, for they and others like them are vital to turning around our global health crisis, in which one billion people still have no health care—millions, even, in the USA. And finally, I hope we will recognize Cuba’s contribution to global health, including the nearly 500 nurses and doctors on the front lines against Ebola in West Africa, as an example of what is possible and as a challenge to others to do more. Today, Cuba has over 50,000 health professionals serving in 66 countries, 65% of them women. Since 1963, 77,000 of them have given their services—and some their lives—in Africa.

What motivated you to speak at TEDMED?

As a journalist in Cuba, I realized I was witnessing an extraordinary experiment in health solidarity with the world’s poorest people: The thousands of scholarships offered by Havana’s Latin American Medical School to students from low-income families in 123 countries, who pledge to serve in communities poor like their own. I was struck by the fact that a country, an institution, believed these young people could themselves be the answer to the call for doctors where there were none. And I was astounded, too, that this audacious experiment has remained essentially an untold story. Audacity is right at home on TEDMED’s stage, so it seemed the perfect opportunity. I also thought the TEDMED audience would ‘get it,’ the urgency and responsibility we all have to support these new doctors, who represent the potential of imagination when commitment drives it into bold action.

What is the legacy you want to leave?

The talk’s legacy is in the hands of thousands of young doctors continuing to graduate from the School in Havana, who are bringing health care to some of the world’s most vulnerable people. Their school and their example should remind us that this is one world, with one fate and one humanity, and that the odds are there to beat: Health for all is possible.  

Want to learn more about Gail and her efforts? Visit her speaker page on TEDMED.com.

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TEDMED Friday: Natural Inspirations, Surreal Designs

Art of Motion Dance Theatre performs at TEDMED 2014 at the Kennedy Center for the Performing Arts

Art of Motion Dance Theatre performs at TEDMED 2014 at the Kennedy Center for the Performing Arts

The third and final day at TEDMED 2014 touched on grand influences: The vast impact of our life events, lifestyles and external environment on our minds and bodies.

We’re all “swimming in an ocean of light” but, like fish in water, are generally unaware of and pay little attention to our environment, said Mariana Figueiro of the Lighting Research Center at Rensselaer Polytechnic Institute. Yet light is the conductor of our internal symphony, influencing when we sleep and wake, our cognitive abilities, how well our medicine works, even how much we eat. Minding your light might include shutting out blue daylight with rose-colored glasses (literally) to ward off jet leg, and avoiding bright artificial light for a couple of hours before sleep.

Jeffrey Karp, co-director of the Center for Regenerative Therapeutics at the Brigham and Women’s Hospital, has invented slug-inspired tissue glues, parasitic worm-inspired micro-needles, jellyfish-inspired cell-sorting chips, and a gecko-inspired medical tape. His advice to other medical technology designers who aspire to co-opt nature’s best designs? Take a trip to the zoo.

We know that our brain influences our actions, but science increasingly points to the crucial role our gut plays in our feelings. John Cryan, neurobiologist at University College Cork, explains how metabolic activity in our gut microbiota can play a role in how our brain functions, particularly in regulating emotions. Research has just begun into how administering helpful probiotics – called psychobiotics – may help improve mental health.

Robin Geunther, a sustainable healthcare architect, took hospitals to task for so often being environmentally unhealthy, both for humans and the environment, from sealed-shut windows and floors waxed with toxins to an outsized energy footprint. Even economic surroundings should be taken into account when building health, she said. “All too often hospitals don’t acknowledge that how and where they spend their money impacts community health, and their focus on saving money via global supply chains bankrupts local communities,” she said.

Physician, chef and TV personality John La Puma shared a recipe for health.

Physician, chef and TV personality John La Puma shared a recipe for health.

Among many other memorable moments: Marc Abrahams, founder of the Ig Nobel Prizes, regaled the audience with stories of the “Weird and Wonderful” winners in the session of the same name. The criteria for winning: You’ve done something that make people laugh, then think. Among the laureates include a papers on “Injuries Due to Falling Coconuts” in Papua, New Guinea and how to minimize colonic gas explosions during a colonoscopy; and a patent for a brassiere that could be converted to a face mask.

Exposure to this risk causes as much as a 20-year difference in life expectancy, but doctors are not trained to spot and treat it. What is it? Childhood trauma. Abuse, neglect or growing up with a parent who has mental illness can cause negative health outcomes that can stretch over a lifetime, including 3 ½ times the risk of heart disease, says pediatrician Nadine Burke Harris, founder and CEO of Center for Youth Wellness. Adverse childhood events literally change the structure of the brain, including fear response, and sends the body’s fight-or-flight response into overdrive. Screening is universal at the Pacific Center, and treatment includes home visits, care coordination, mental health care, nutrition and holistic interventions.

Resa Lewiss, Associate Professor of Emergency Medicine and Radiology at the University of Colorado School of Medicine, sees a future in which the powerful technology of ultrasound will be wireless, portable and relatively inexpensive. “Point of care ultrasound is one of the most disruptive innovations to hit healthcare in a long time, “ she says.

A fanciful prosthetic from Sophie de Oliveira Barata’s studio. Photo courtesy of the Alternative Limb Project.

Sophie de Oliveira Bariata stunned the audience with photos and an in-person model of her imaginative prosthetic art. From the minute details of realism, like the tiny hairs on a toe, to fanciful mini-murals, she creates limbs according to how clients perceive themselves and seek to move on all levels in the world. As one woman said of her ornately painted leg, “[It's not real], so why not make it surreal?”

For more on the speakers of TEDMED 2014, visit TEDMED’s Tumblr page.

 

TEDMED 2014 Day Two: Thinking Hard, Playing Hard

The second day of TEDMED tackled some of the toughest topics in health and medicine, including addiction and the growing plague of antibiotic resistance, with musings on the power of transparency and simple play.

What can human doctors learn from veterinarians? Quite a bit, as Barbara Natterson-Horowitz, Professor of Medicine in the Division of Cardiology at UCLA Medical School, revealed. From recognizing and treating issues from postpartum depression to heart disease, physicians would be well served to learn from veterinary medicine for tips on how to treat human animals, she said, adding, “What do you call a veterinarian who can take care of only one species?  A physician.”

Abraham Verghese, professor at Stanford University’s School of Medicine, spoke of the metaphors in medical language, and why illnesses and healing present compelling human stories (perhaps why so many doctors are also wonderful writers).  “Anybody with a curiosity for the human condition, with the willingness to work hard, and with an empathy for fellow humans, can be a great physician,” he said.

Can eating be addictive? Nora Volkow, Director of the National Institute of Drug Abuse, explained a bit of the neurobiology behind why drug addiction is not a moral failure due to a reduction in dopamine receptors – which holds true for those addicted to food as well.

“Addiction and obesity have been stigmatized and dismissed as disorders of poor self-control, self inflicted, personal behavioral choices. I never ever met an addicted person who wanted to be an addict, nor have I ever met an obese person who wanted to be obese. Can you imagine what it must be to want to stop doing something, and not being able to?” Volkow said.

Carl Hart

Carl Hart

Carl Hart, who emerged from a youth of petty crime and drug use to teach psychology and psychiatry at Columbia University, also weighed in on myths of addiction. Up to ninety percent of those who use illegal drugs are not addicts, he said, and drugs don’t necessarily lead to a life of indigency and crime. “We certainly were poor [in my neighborhood] well before drugs entered the picture,” he said, and criminalizing drug possession only contributes to a downward spiral.

In the session appropriately titled, “Don’t You Dare Talk About This,” organ donation advocate Sigrid Fry-Revere spoke of the hurdles of kidney donation, from getting an organ to giving one. Her proposition: Why not help donors financially, as other countries do to good effect, most notably in Iran.

Dr. Leana Wen urged doctors in the audience to declare any financial incentives – including to do more or less treatment – that may influence their decisions in the “Total Transparency Manifesto” movement she founded.

Carla Pugh had a call to medicine as well – to take training beyond pen-and-pencil tests to extended haptic training. A childhood spent fixing things, a life-or-death moment in the ER, and her own research into how often med students miss bodily cues, led to her creating her own patented haptic training tools.

Carla-Pugh_10

Carla Pugh

Science writer and author Kayt Sukel spoke of the neurological benefits of risks — and risky play — even though some choices, particularly those kids make, look silly to the rest of us. There’s a big cognitive payoff in terms of brain growth to new experiences, she said, and an especially big bounce when gambles pay off. It also pays to expect the unexpected; “Every single day is a risky one, because in this life there’s very little that is guaranteed,” she said.

Click here for speaker highlights from Day One of TEDMED 2014.

The TEDMED Hive: Immersion Into Imagination, Innovation and Conversation

The Imagine Wall in San Francisco

The Imagine Wall in San Francisco

If the TEDMED 2014 stage is the brain imagining health, The Hive is its beating heart.

For starters, it showcases some of the smartest and potentially revolutionary ideas in health in an up-close-and-personal forum, in which start-ups can gather ideas from other Delegates and from each other.  It’s been a launchpad for a number of game-changing companies.

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Ed Hamblin, Director of Sales for Sensiotec, has his vitals measured by Sensiotec’s Virtual Medical Assistant, a non-contact patient monitor.

This year, 80 entrepreneurs – 40 on each coast – have a chance to share their stories with TEDMED attendees and the world, from technologies that help kids track their blood sugar and diagnose brain injuries by tracking eye movements, to a brilliantly simple pill pack design that promotes medicine adherence and a technology application where patients can get a doctor’s house call on demand within two hours.

There’s also an opportunity to visualize progress; the Imagine Wall – seen above in its San Francisco incarnation – is a mural of Twitter responses to the question, “How would you imagine a healthier world?”

The Hive was conversation central for the Great Challenges program, a platform for discussing complex public health issues. Delegates also had a chance to talk over some of the biggest questions in health and science over at the Campfire, an intimate space that presented thought experiment questions to small groups.

The Campfire

The Campfire

Hot topics: Getting approval and a market plan for niche medical devices; the increasing dearth of primary care physicians, and what medical education should do about it, and how the world can solve the health conundrum of having undernourished populations in most of the world, and overweight, overfed people in many others.

 

Raising H.E.A.L.T.H. at TEDMED

RaisingHealth-DC-20

Among the many activities at TEDMED 2014, Delegates were invited to contribute their thoughts to “Raising Health” – ideas on how to approach some of the most broad-based, intractable issues of health today, from childhood obesity to medical costs.

On Day One of TEDMED, Delegates focused a great deal of attention in the space to the changing role of the patient in healthcare.  They were asked to discuss and respond to the following questions: How do we empower patients to make healthier decisions? What is the patient’s role from his or her perspective? What is the role of healthy people  (non-patients) in healthcare?

Answers centered on a number of themes:  What are the best ways to develop a strong doctor-patient conversation? How can we include family, caregivers and community in patient care? An informed patient is an empowered patient. What’s the best way to go about that?Screen Shot 2014-09-11 at 9.32.15 AM

“Bring intuition and knowledge of your own body to your healthcare team,” answered one Delegate. “Make the patient the source of applied innovation,” said another. And, “Ask each patient for his or her goal for each visit or what he/she wants to accomplish.”

Click here for a recap of more thoughts on this critical issue, and stay tuned as we cover more thoughts on the Challenges throughout TEDMED. You can also share your own thoughts on Twitter at #greatchallenges.

TEDMED 2014: The First Day

The first-ever two-city TEDMED 2014 began this morning. Some 2,000 Delegates, 90 speakers and performers, corporate partners and 80 start-ups converged at the Kennedy Center for the Performing Arts in Washington, DC and the Palace of Fine Arts Theatre in San Francisco, CA.

For the first time, performances on two stages were virtually linked by simulcast.  “Hello, DC!” University of California, San Francisco neuroscientist and TEDMED co-host Adam Gazzaley greeted inventor and Massachusetts Institute of Technology PhD candidate  David Moinina Sengeh, who co-hosted in DC. The stage program was simulcast to some 150,000 viewers in 142 countries as well.

David Sengeh, at left and foreground, and Adam Gazzaley.

David Sengeh, at left and foreground, and Adam Gazzaley.

Among the highlights of the first day’s talks: The event’s first speaker, journalist Sonia Shah, discussed why humans should regard pandemics less as foreign invasions and more as an ever-present enemy that require changing our own actions and environment to eradicate.

Danielle Ofri, attending physician at Bellevue Hospital, hit a nerve with the audience and dozens of Tweeters by telling the story of how she nearly killed a patient – and didn’t tell a soul for 25 years. Rather than the current “toxic culture of perfection” in medicine, the field would do better to recognize that error is intrinsic to normal human functioning, she said, rather than burying them as rare events or attacking with litigation. For starters, medical leaders should talk about their own mistakes, she said.

Harvard Medical School Professor Ted Katpchuk studied herbalism and acupuncture for years in China, which led to his ongoing investigations into the measurable power of the placebo effect. After all, “Many drugs already mimic what the body can already do,” he said. The brain functions as a prediction machine, so just entering an environment designed to help patients, with its rituals and symbols, jump starts healing mechanisms, he said.

Eleanor Bimla Schwarz discusses the many and surprising benefits of breastfeeding for mothers at TEDMED 2014.

Eleanor Bimla Schwarz discusses the many and suprising benefits of breastfeeding for mothers at TEDMED 2014.

TEDMED Curator Jay Walker spoke about how imagination powers health and medicine, the theme of TEDMED 2014. “Health and medicine is about to change more in the next 20 years than in the last 20,000,” Walker said, mentioning five “superforces” that would revolutionize the field, including synthetic biology, and wearable micro-sensors and tele-medicine that will deliver continuous, real-time health monitoring.

Elizabeth Nabel, the President of Brigham and Women’s Hospital and a professor at Harvard Medical School, reminded the audience knowledge is fleeting, and that clinging to the known rarely serves medicine, while “real progress is about changing dogma…to venture into the unknown with intellectual humility.”

“Violence is not ingrained in American culture or law,” said Daniel Webster, Director of the Johns Hopkins Center for Gun Policy and Research, who suggested that gun deaths be reduced through standards most gun owners could agree upon, including prohibiting ownership for those who have been convicted of a violent crime, and accountability for gun dealers.

The indomitable Diana Nyad spoke at the last session of the day, Flat Out Amazing, which describes her achievement in swimming the 110-mile ocean crossing between Cuba and Florida.

Elizabeth Holmes, founder of Theranos and its heralded technology of producing a viable blood lipids profile from just a drop of blood, famously dropped out of Stanford at age 19 to develop her company. Her mission is to develop truly consumer-oriented, affordable health data technology allowing individuals to anticipate and prevent disease.

Another undaunted inventor, Marc Koska, who devised an auto-disable syringe that has been credited with saving some nine million lives, spent three decades bringing his idea to efficacy. The climax of his talk: the World Health Organization will announce a global initiative to improve injection safety this October.

Here’s a Challenge for you: How can we Raise Health?

shutterstock_180808967We’ve seen the power of collective creativity and goodwill for a good cause recently, so we’re asking our health and medicine community to dig deep once more, this time for a thought experiment: Can we rebuild some of health and medicine’s most complex and critical issues – our Great Challenges – by creatively rethinking their foundations? What do we truly understand about these factors that limit health —and their possible solutions— today?

As we move into the third year of our Great Challenges program, Delegates on site at TEDMED 2014 in Washington, DC and San Francisco will be tackling these issues and more in a special area devoted to exploring the six Challenges we’ve focused on this year. Together, we’re aiming to shake up the status quo, rethink assumptions, and raise health to new heights to meet our evolving needs.

Your input will also help guide direction for the Great Challenges program in the coming year, so be sure to stop by.

Below, find 18 critical questions as determined by our community.  Answer them, validate them, reframe them. We need your input, so please respond here, via Twitter #GreatChallenges, on Facebook and Google+, or on our tumblr.

Impact of Poverty on Health

What’s the best way to invest in poverty reduction to improve health?

Are other people’s health problems everyone’s business?

How should doctors “treat” socioeconomic factors that impact health?

Reducing Childhood Obesity

How can we change our 24/7 food-everywhere culture?

Obesity risk begins in the womb. How can we deliver this message?

How much of obesity is about personal responsibility?

Achieving Medical Innovation

When should patients get to enter higher-risk clinical trials?

How can we align public and private interests to drive innovation?

How can patients be partners in medical innovation?

Making Prevention Popular

Where could health policy go farther to nudge preventive behavior?

Why do we so often do what we know isn’t good for us?

Is prevention about individuals, populations, or both? Why?

Role of the Patient

How do we empower patients to make healthier decisions?

What is the patient’s role from his or her perspective?

What is the role of healthy people  (non-patients) in healthcare?

Addressing Healthcare Costs

How do we create smart “healthcare consumers”?

What kind of system adapts to the changing needs of healthier patients?

How can we align stakeholders to reduce healthcare costs?

Special thanks to the Robert Wood Johnson Foundation for their support of this program.

TEDMED 2014 Session Nine: I Was Just Thinking Too Small

When Robert Hooke looked into a microscope and decided the structures he saw should be named cells, it was an epic moment for scientific probing. It has brought to fruition the longing to see how things really work at their most basic levels, and the ingenuity to devise ways to explore.

Sometimes, however, approaching a mystery or positing a breakthrough means stepping back and applying a wider lens. What if solving a problem means reframing it entirely?

This ninth and final session of TEDMED 2014 is all about taking a look at the bigger picture.

Tomorrow is your last day to register, so don’t miss your chance to join us September 10-12 in Washington, DC and San Francisco, CA.

Screen Shot 2014-09-02 at 3.11.29 PMScreen Shot 2014-09-02 at 3.11.47 PMScreen Shot 2014-09-02 at 3.11.58 PMScreen Shot 2014-09-02 at 3.12.08 PMExplore our full stage program to learn more about all the speakers who will take the TEDMED stage in just over a week, and stay updated by following @TEDMED on Twitter.

TEDMED Speakers: Exploring the Weird and Wonderful

TEDMED 2014 is less than two weeks away! We’re excited to highlight the second to last session and its speakers, who will be part of TEDMED 2014 this September 10-12 in Washington, DC and San Francisco, CA.

Sometimes, progress happens unexpectedly – in ways you’d never looked for and may not even be able to explain. This session’s wildly creative thinkers will be sharing stories of “Weird and Wonderful” discoveries that came out of the blue, defied expectations, and achieved remarkable results.

Screen Shot 2014-08-28 at 2.47.12 PMScreen Shot 2014-08-28 at 2.47.23 PMScreen Shot 2014-08-28 at 2.47.33 PMScreen Shot 2014-08-28 at 2.47.42 PMScreen Shot 2014-08-28 at 2.47.53 PMThese remarkable out-of-the-box thinkers will expand your reality and make you take another look at what’s “weird” around you.

Explore our stage program for more details on these and other speakers – and don’t forget to keep up with TEDMED by following @TEDMED on Twitter.

The Upside of Human Nature

From our primal instincts to the unfolding mysteries of how our complex brains evolved and work, humans are amazing and often unfathomable creatures. But if we don’t yet understand everything about ourselves and our surroundings, it’s not for want of trying. Scientists, artists, clergy, and indeed all of the curious among us haven’t given up trying to discern what makes us tick.

This session of TEDMED will explore what we’re learning about the human body and our inner worlds, what elements aid our bodies’ ability to heal, and how what we think of as our external environment is critical to our well-being and, in the end, is a large part of who we are.

Join us September 10-12 as these speakers, and many others, help us unlock imagination in service of health and medicine.

Art of Motion Dance Theatre
Modern Repertory Dance Company
Drawing from contemporary and classic legacies, as well as from yoga and eastern philosophies, AOMDT creates vital works inspired by earthly and imaginary worlds.

Julian Treasure
Sound Evangelist
Julian Treasure is chairman of The Sound Agency, a consultancy advising worldwide businesses on how to design with sound, especially in public or branded spaces.

Mariana Figueiro
Illumination Researcher
Brazilian-Cuban architect and scientist Mariana Figueiro researches the effect of light on humans, including alertness, performance, and cognition.

Jeffrey Karp
Bio-Inspired Innovator
Canadian Jeff Karp’s research focuses on stem cell engineering, biomaterials, and medical devices inspired by nature.

Emery Brown
Anesthesia Neuroscientist
Computational neuroscientist and anesthesiologist Emery Brown explores one of medicine’s big mysteries—exactly what happens to your brain under anesthesia?

Uzma Samadani
Brain Trauma Detective
Uzma Samadani is cofounder of Oculogica, a neurodiagnostic company specializing in detecting brain injuries using a non-invasive, bedside eye-tracking technology.

Debra Jarvis
Irreverent Reverend
For writer, ordained minister, and hospital chaplain Debra Jarvis, humor is a powerful balm, even for the sick and dying.

Zsolt Bognár
Concert Pianist
Concert pianist Zsolt Bognár, who frequently performs on NPR and has garnered critical acclaim, will perform a work by Schubert.

Tiffany Shlain
Interconnected Filmmaker
The work of filmmaker, author, artist, and Webby-awards founder Tiffany Shlain catalyzes deep thought about the future and how we want to live it.

Jen Hyatt
Global Social Entrepreneur
Jen Hyatt is the founder and CEO of Big White Wall, a digital behavioral health service including peers, professionals and evidence-based third party providers.

Peggy Battin
End-of-Life Ethicist
Philosopher and bioethicist Peggy Battin has worked for decades to defend the right of terminally ill individuals to have greater control over the timing and manner of their deaths.

Inspector Gadje
Balkan Brass Band
With up to 15 musicians, San Francisco-based Inspector Gadje brings a big sound to the beautiful and bumpin’ brass band music of the Balkans.

Click here to see the entire TEDMED 2014 stage program, and here to join our event – just 16 days away! – in Washington, DC or San Francisco, CA.

Stay up-to-date by following @TEDMED on Twitter.