Charting the Next Course: Women Speak from a Mighty River

By Christine McNab, guest contributor. Can Tho, Viet Nam

She’s petite, yet stands tall and steady, strong shoulders and arms steering eight foot-long oars through a swift Mekong current. It’s dawn, and many women do the same, navigating their low wooden boats through a jigsaw of vessels at the Phong Dien floating market. Women here do a brisk trade in produce, exchanging pounds of watermelon, daikon, pineapple, cabbage, morning glory, onion and squash for Vietnamese Dong. The bounty from the Mekong Delta provides much of the food energy for Vietnam’s 90 million people. Women are at the heart of this essential commerce.

“Vietnamese women are often in charge of driving the small boats, and buying and selling at the fruit and vegetable markets,” says Maru, my guide. The work is taxing – a technique combining crossed arms and oars to nudge the boat through narrow spots; a one-legged start of a long motorized rotor for speed, and hours under a searing sun. Our driver, Tay, has been steering boats for more than twenty years. “Women here work very hard,” Maru tells me.

I want to find out a lot more about Tay and Maru, and I will this week as part of my new multimedia project, A River Runs with Her: the Lives of Women and Girls on the Mekong.

Near Can Tho, Viet Nam, March 2016. Photo: Christine McNab

Tay has done the hard work of steering boats on rivers and tributaries of the Mekong Delta for more than 20 years. (Near Can Tho, Viet Nam, March 2016. Photo: Christine McNab)

I’m devoting 2016 to this self-funded project for many reasons. For one, I believe attaining gender equality is at the heart of international development. Many studies, history, and a lot of common sense tell us that we can only make progress when women have the same rights, access to education, health, jobs and justice as men. Women have made great strides in much of the world, but in too many places, women and girls are simply valued less. Equality means equal value, and it also means equal voice.

We don’t hear from women enough. The Economist recently published an excellent essay on the importance of the Mekong River to biodiversity, culture, and Asia’s economy. I admired the reporting, but noticed there wasn’t a single female voice in the piece. Instead, women were in the kitchen making soup or in bars serving beer. I want to hear more from these women.

The newest international Global Goals for Sustainable Development, set by international leaders last September, include important targets for women’s equality, for education, health and participation in governance. The goals are hopeful and ambitious. I wondered what women living in communities along the Mekong think about these goals? What do they need to achieve them?

And then, there’s the mighty Mekong itself, a legendary, 2700-mile artery connecting six countries, many cultures and one of the most bio-diverse areas of the world. Its waters are a lifeblood for millions. As the climate changes, the Mekong, and the traditions and economic lives of millions are changing with it.

Tay doesn’t speak much as she drives her boat down a Mekong Delta tributary. But I want to know what she thinks about all of this. I think it’s her time, and time for all women, to tell the world what they think.

Learn more about A River Runs with Her project in this 1-minute video.

To follow the project, see www.ChristineMcNab.com, add http://www.christinemcnab.com/her-stories/ to your RSS feed, or follow along on Facebook.
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Christine McNab is a global public health worker and communications expert. Her TEDMED talk illuminates the story of how she combined her passions and partnered with the Gates Foundation to create what might be the most artistically crafted vaccine promotion campaign ever.

New Genetic Spectra Across Earth’s Cities & Far Beyond

by Chris Mason, guest contributor

Since speaking at TEDMED 2015, there have been a number of updates to the science I described in my talk. These areas include: space genomics, beer-omics, extreme microbiomes, global city metagenome sampling, epitranscriptome discoveries in RNA viruses, and DNA as music in microgravity.

Image based on images courtesy of ShutterstockSpace Genomics and Genomic DJs

First, we have completed the first whole-genome sequencing profile of two astronauts’ genomes (the Kelly Twins). Also, in collaboration with our NASA collaborators, (Aaron Burton and Sarah Castro-Wallace) we have been sequencing DNA in microgravity; this will be used for 2016 plans to send an Oxford Nanopore Sequencer onto the International Space Station with astronaut Kate Rubin. We are preparing for the return of astronaut Scott Kelly to Earth next week, and are strategizing how to make genome-guided medicine a part of the standard of care for new astronauts. Our goal is to monitor, protect, and potentially repair astronauts’ biology through an integrated view of the layers of the genome, transcriptome, proteome, all the epi-omes, and the microbiome.

In collaboration with Harvard Medical School’s Consortium on Space Genetics, we’ve formally launched a new research focus for Weill Cornell medical students on the study of space genetics and aerospace medicine. This allows new medical students to learn and train in the methods of space genomics, data analysis, and new technology development for space missions. They’re also trained in synthetic biology, materials science, nanofabrication, microbiome engineering, and gene drives. These skills are taught in our class called “How to Grow Almost Anything (HTGAA) – NYC” that is part of the BioAcademany. Work by Elizabeth Hénaff in the 2015 class also helped with our plan for the Gowanus Canal and extreme microbiomes.

Extreme Microbiomes

Microbiomes can lead to a bounty of discovery for new biology, drugs and molecules. We have been systematically hunting for these microbes around the world as part of the eXtreme Microbiome Project (XMP). Among those sampled sites, we have already found that Brooklyn’s Gowanus Canal, a SuperFund site, holds a suite of unique and potentially protective microbes, and we have been designing artificial sponges to hold these in the canal during the remediation process. This is part of a larger project of urban microbiome monitoring and design, called the Brooklyn Bioreactor, which is a collaboration between our laboratory at Weill Cornell, the landscape architecture firm Nelson Byrd Woltz, the Gowanus Conservancy, and the community laboratory Genspace. Lastly, in collaboration with Shawn Levy at HudsonAlpha, we have started collecting data about beer microbiomes, which show an interesting blend of differences depending on the yeast strain used.

Global Metagenome Collection Day

The Metagenomics and MetaDesign of Subways and Urban Biomes Consortium has now reached 43 cities around the world, and a global City Sampling Day (CSD) event is planned for June 21, 2016, to match the collections of the global Ocean Sampling Day (OSD) group. These seasonal molecular snapshots will begin to expand our search for novel microbiomes, new molecules, will aid us in mapping the distribution of antimicrobial resistance (AMR) markers, and enable a better understanding of urban biology and ecosystems.

Epitranscriptome Discoveries and Sounds of RNA

Last but not least, we have just published the first demonstration of another realm of RNA modifications, collectively called the “epitranscriptome.” Specifically, we show that HIV’s RNA genomes also harbor modified RNA bases, and they impact how infectious the virus may be for a patient. We are now on a search across all RNA viruses to see how common these types of modifications are. We are also working to get direct RNA sequencing in nanopores operational, to enable listening to the “music” of the genome as it moves through the pore, as we demonstrated was possible with single enzymes in 2012. These methods and algorithms can help us discern new and peculiar nucleic acids that might be found not only in our lab, but in far-flung places on Earth and beyond.

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In his TEDMED 2015 talk, geneticist and urban metagenome researcher Chris Mason of Weill Cornell Medicine shares how he’s mapping his expertise into the distant future of outer space in the interest of humanity’s interplanetary survival.

Why do doctors practice race-based medicine?

by Dorothy Roberts, guest contributor

Biological scientists established decades ago that the human species can’t be divided into genetically discrete races. Social scientists have shown that the racial classifications we use today are invented social groupings. And historians of medicine have traced doctors’ current practice of treating patients by race to justifications for slavery. Doctors I’ve talked to readily concede that race is a “crude” proxy for patients’ individual characteristics and clinical indicators. Countless patients have been misdiagnosed and treated unjustly because of their race.

So why do doctors cling so fiercely to race-based medicine?

BWSyringe2One reason is force of habit. For generations, beginning in the slavery era, medical students have been taught to take the patient’s race into account. Race is built into the foundations of medical education, which assumes that people of different races are biologically distinct from each other and suffer from diseases in peculiar ways. What’s more, medical students aren’t given much latitude to question the lessons they are taught about race.  Without a radical disruption, these students go on to train the next generation of doctors with the same flawed racial dogmas.

Another reason is that doctors aren’t immune from commonly-held racial stereotypes and misunderstandings. Most Americans believe some version of a biological concept of race, and doctors are no exception. In fact, the entire field of biology has been plagued by controversy and confusion over the meaning of race. It is not surprising that the medical profession would be influenced by racial thinking that has been perpetuated in U.S. education, culture, and politics for centuries.

In addition, there are institutional and commercial incentives to continue practicing medicine by race. Starting in the 1980s, the federal government required the scientific use of racial categories to ensure greater participation of minorities in clinical research and to address health disparities. Unfortunately, this effort to diversify clinical studies focused on biological rather than social inequalities and has reinforced genetic definitions of race.  In 2005, the federal Food and Drug Administration approved the first race-specific drug, a therapy for African-American patients with heart failure, that was repackaged as a race-based pill to enable the cardiologist who developed it to obtain a patent. Labeling drugs by race may be financially advantageous to pharmaceutical companies by providing a marketing niche and an avenue for FDA approval. The biomedical research and pharmaceutical industries have tremendous influence over how medicine is practiced.

Doctors are quick to bristle at any suggestion that treating patients by race results from their own racial prejudice. They disavow any connection to blatantly racist medicine of the past—the horrific treatment of enslaved Africans; unethical medical experimentation on African Americans, such as the Tuskegee Syphilis Study and use of Henrietta Lacks’ cancer cells; Jim Crow segregation of medical services; and mass sterilization of black, Mexican-origin, Puerto Rican, and Native American women in the 1960s and 1970s.

Doctors argue that they are using race for benevolent reasons or, at most, as a benign way to classify their patients. But race is not a benign category. Race was invented to support racism and it is inextricably tied to racial oppression and the struggle against it. There is no biological reason to divide human beings into white, black, yellow, and red. Race seems natural only because we have been taught to see each other this way. Sometimes, when I speak to doctors about this topic, I can see their physical discomfort with giving up their reliance on race. It feels like asking deeply religious people to give up their belief in their deity. Race is more than an ordinary medical feature—it is part of people’s deeply-held identities, their sense of their place in society, and their view of how the world is ordered. This is why ending race-based medicine will require a great leap of imagination, a new vision of humanity tied to a movement for racial justice.

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Global scholar, University of Pennsylvania civil rights sociologist, and law professor Dorothy Roberts exposes the myths of race-based medicine in her TEDMED 2015 talk.

2015 Speakers: A Look Behind The Scenes

Raj Patel

Raj Patel conducts an interview for his film project “Generation Food,” a documentary that will be released in 2016. An author, activist and academic, Raj is breaking through “people’s fear of systemic change by showing how some of the world’s poorest people are saving the planet through food.”

In Food Fix, Raj Patel will introduce a novel “technology” to global farming that can help decrease chronic child malnutrition and ensure food sovereignty. Knowing where to start isn’t easy, he tells us, sharing that “Many people want to change the world, but the ways we’re allowed to do it are trivial. Voting for one party or another doesn’t help. Shopping sensibly or voting with our forks doesn’t do a whole lot. But the minute we stop thinking about ourselves as individual consumers – whose only power is to shop – and think of ourselves as agents and scientists for change, new things start to become possible.”

What sparked Raj’s commitment to ending poverty? He shares the compelling experience: “I was five years old visiting Bombay, and couldn’t understand why a little girl was begging at a traffic light in the monsoon rain. It struck me as unspeakably unfair. As soon as I got back to England, I rented out my toys at kindergarten, and sent the money for hunger relief. It was an early career change. And I’ve yet to find a good reason why she was outside our taxi, and we were inside it.”

Raj Patel at work

Little boys from Bwabwa, Cameroon, make sweet potato donuts

Bwabwa, Cameroon.

Bwabwa, Cameroon

 


 

Dr. Dilip Jeste

In his office at UCSD, geriatric neuroscientist Dr. Dilip Jeste specializes in wisdom and other positive attributes of the aging brain.

“I am #Breakingthrough stigma against aging by discovering how late life can be a period of wisdom and growth – a time to thrive, not just survive,” says Dilip Jeste.

Dilip’s goal is timely, especially considering increasing life expectancy rates worldwide. He urges us not to view the aging demographic as a financial burden on the healthcare system, but as a valuable resource. Rather than the pejorative term “Silver Tsunami,” he tells us that it is instead “a Golden Wave of wise, emotionally stable, experienced decision-makers with a generative world view and a great deal to offer the younger generations.”

Dilip has no plans to slow down. “In 2008, for the first time in my life, I ran for a public election as a Trustee-at-Large of the American Psychiatric Association (APA), the largest psychiatric organization in the world, with 35,000 members. The election involved political-style (but fortunately, without negative ads!) campaigning, seeking votes from a large and diverse body of members scattered across the country, giving presentations on why I was the best of the three candidates who were running for the position.” It wasn’t comfortable, he says, calling himself a “heavy underdog” at the start of the campaign. “Many friends and colleagues thought that I was risking my personal reputation by venturing outside the comfort zone of the academic ivory tower. Yet, I felt it was a great opportunity for me to get to know the world beyond academics and also to see if I could adapt myself to public campaigning. I won the election, while enhancing my friendship with the other two candidates.” He didn’t stop there. “After serving as the Trustee-at-Large for 3 years, I ran for APA Presidency, which was an even more demanding campaign. I won and in 2012 I became the first Asian American President in the 168-year history of this organization. It turned out to be one of the most fulfilling years of my life.”

 


 

Breakout Labs

Breakout Labs, workplace of Hemai Parthasarathy, Scientific Director of the Thiel Foundation and Breakout Labs and a speaker in our Catalyzing Great Science session.

Through her work at the Thiel Foundation, Hemai Parthasarathy tells us that she is “breaking through barriers between the laboratory and the economy.” At TEDMED, she will reveal what goes on behind the scenes of cultivating a scientist-entrepreneur and providing them with the tools to thrive.

But what about what happens behind the scenes outside of work? Curious to know, we asked her to tell us about the last time she did something for the very first time. Here’s what she shared: “In February, I started training a puppy for the first time. My family had dogs when I was growing up, but I’ve never raised a puppy before and it’s been fascinating to coach a non-human animal mind. Although I did animal research as a neuroscientist, watching non-human animal cognition and its evolution on a daily basis has given me a new perspective on just how fundamentally different and how utterly similar a different species’ brain can be.”

 


 

Vanessa Ruiz

Drawing from her love of street art, Vanessa Ruiz wants to break through “the confines of medical education by making human anatomy publicly accessible through art, design, and pop culture.”

Vanessa Ruiz’s company, Street Anatomy, is working on an online collection of top contemporary artists who use human anatomy in their art. She wants to shift public ignorance of human anatomy, saying “Most people know more about the settings on their smartphones than where their organs are located. I am attempting to make anatomy more accessible by showing how it is visualized outside of the realm of education—to break through the lack of interest, aversion to the internal, and perceived complexity. It is a step in making anatomy more ubiquitous and interesting.”

Vanessa Ruiz's office

A look into Vanessa’s office.

“OBJECTIFY THIS," curated by Vanessa Ruiz

In 2012, Vanessa curated a gallery show titled “OBJECTIFY THIS” that uses art as a vehicle for education. “I became more aware of the underrepresentation of female anatomy in medical textbooks and education,” she says. “The male body has always been the educational standard, possibly to the detriment of learning female anatomy. I have found that in art, there is no preference. It all depends on their frame of reference and experiences. I want to continue the theme of OBJECTIFY THIS and bring it to other cities around the world to educate the public on this overlooked issue.”

Transcendence: TEDMED2015 Speakers Share Inspirational Stories of How Personal Struggles Fueled Their Accomplishments

A number of TEDMED2015 speakers and performers have faced personal struggles head-on. Not only have they have risen above painful circumstances, they have utilized them to power meaningful change and improve the world for others. Here are a few of their stories:

Retina image

Actual images from the donated retinas of Thomas Gray.

Retina-Inspired Watercolor

Watercolor painting by artist by Michele Banks, inspired by the images from the donated retinas of Thomas Gray.

While struggling to cope with the loss of their 6-day-old son Thomas, Sarah Gray and her family chose to personally seek out and meet the researchers who received his eye, liver, and cord blood donations. Their journey brought profound peace to the Gray family, and in the process, garnered national and international media attention. Sarah is writing a ‘medical memoir’ about the experience, scheduled for publication next year. She says, “It will be a medical detective story in which I, a mother of twins, one of whom succumbs to a fatal genetic defect, recount the decision to give our infant son’s organs to medical science and my subsequent quest to find out what happened after the donation, taking readers to the cutting edge of research, inside other families’ stories, and what it means to come to terms with loss.”

Sarah recalls a profoundly moving moment, when the researcher who received her son’s retinas confided that she felt guilty about wishing to obtain a specimen of this type, because it is only available after a child dies. “It never occurred to me that a researcher would feel guilty about this, but now I understand why. I actually laughed when she said it. I asked her to never feel guilty about this, because if her study didn’t need my son’s retinas, they would be buried in the ground and not helping anyone. I am grateful that her research gave my son’s life an added layer of meaning.”

Thomas’s retinas have proven very useful—the researcher had been searching for six years for such a sample for her study of retinoblastoma, a deadly childhood cancer. “My son’s retinas were the only suitable specimen of healthy tissue that she has ever received,” Sarah proudly says.

Laurie Rubin

“I think of myself as a three-dimensional coloring book” says inspirational diva Laurie Rubin, whose blindness doesn’t stop her from designing jewelry, applying her own makeup, going skiing, or pursuing life’s other adventures.

Blind since birth, mezzo-soprano Laurie Rubin (one of our featured performers) has performed at Lincoln Center, the Kennedy Center and the White House, and is co-artistic director, co-founder and resident voice teacher of Ohana Arts Summer School of the Arts in Hawaii. Luminous as her voice and story may be, a thread that runs through her work is her experience of having been bullied as a child. In collaboration with composer (and wife) Jennifer Taira, Laurie released a song and music video, which features the stories of women overcoming the effects of bullying. Laurie also recounts the isolation she felt as a victim of bullying in her memoir, Do you Dream in Color? Though the memoir is primarily filled with thrilling stories and adventures from her life, Laurie finds that it is the day-to-day struggles that she describes that resonate most with her readers. Many wrote to Laurie, telling her they’d expected to read about a blind girl but “came away from it realizing I had just read a book about myself.” With a goal of promoting dialogue and forgiveness, Laurie tells us that, “Our experiences are universal, and we all have more in common than we think in spite of our differences.” Not only that – she challenges those “who feel their weaknesses hold them back to not only dream big, but to gather all the skills and tools they can to achieve their big dreams, no matter how hard it may seem to achieve them.”

Seun Adebiyi

Cancer survivor Seun Adebiyi will be Nigeria’s first Olympian to compete in both winter and summer games.

One week after graduating from Yale Law School, and one week before his 26th birthday, Seun Adebiyi was diagnosed with two aggressive forms of cancer – lymphoma and leukemia. With a grim prognosis, he was given only months to live. His best chance of survival was a stem cell transplant. However, having fully African ancestry, Seun struggled to find a donor. Less than 17% of Africans are able to find a donor to match their blood type and only 8% of registered donors in the US are black. While he was still fighting his cancers, Seun launched a Bone Marrow Donors Registry and organized the first bone marrow drive in his native Nigeria. Now fully recovered, Seun is training to become Nigeria’s first Winter Olympic athlete. He also directs the American Cancer Society’s Global Scholars program, training advocates to advance cancer screening, treatment, and palliative care in under-resourced, low-income countries.

When asked what his clone would do (if he had one), Seun responded: “I don’t need to clone myself. I work full time for the American Cancer Society and part-time for Uber; train for two Olympic sports; and still have enough time to earn a pilot’s license and a massage therapy degree. I’m also an avid student of yoga and meditation, and I enjoy taking mid-day naps.”

Inventors Who Solve For Complexity

 

“Have you broken this thing yet? No? Well, then, you are running behind schedule.”

That’s what Peter Janicki, founding engineer of Janicki Industries and a speaker in our Back to Basics session, asks himself when he’s tackling each of the large and complex challenges his 600-person family-operated engineering firm specializes in solving. With a portfolio that includes major architectural projects, transportation, and now sanitation, they’ve created an ecologically sound, inexpensive toilet to help improve conditions in developing countries. Requiring no electricity, plumbing or even water, the toilet is self-contained, derives all of its energy from fecal matter input, and produces only a bit of ash. “It does seem almost too good to be true. That was the only way it was going to work economically,” says Peter.

Peter Janicki, Founding Engineer of Janicki Industries

Peter Janicki, Founding Engineer of Janicki Industries

Peter’s working philosophy – which has contributed to his company’s unique innovations – was shaped at an early age. Peter recalls being 12 years old and spending the day at work with his father in the family logging business. It was a long slog, and the kind of day when many things went wrong. It was also Friday – pay day.

“The entire crew, about 120 employees, were in the shop when my dad walked in. Right there were our own two dump trucks, completely smashed, from crashing into each other. There was dead silence as my dad walked over and inspected the trucks. The radiator and engine block on both engines were cracked. Without saying a word he walked out to his pickup truck and grabbed two cases of beer, set it on the workbench in the middle of the shop and said, ‘Boys, tonight the beer is on the house.’ And he sat and drank and visited with the crew for more than an hour. My dad never got mad at the crew when things went badly.

“This had a profound impact on how I interact with my crew today. I strive to create an environment where the penalty for failure is very small. This creates freedom because people are not scared. Freedom promotes innovation and innovation promotes rapid technology advancement.”

Optimizing for freedom to innovate is the principle that also powers MakerNurse, where co-founder Anna Young (another Back to Basics speaker and a Hive 2015 innovator) operates from a fundamental belief that nurses (and other healthcare providers) can create innovations that improve patient care when empowered with the right tools and unafraid to try. “The everyday ingenuity of people will solve many of the health technology challenges in healthcare today,” Anna shares.

Anna Young, Co-Founder of MakerNurse

Anna Young, Co-Founder of MakerNurse

MakerNurse creates Medical Maker Spaces with tool kits that are, essentially, “miniaturized” world-class medical device R&D facilities to create affordable DIY health technology solutions to customize care.

“The history of medical making runs deep through every part of the healthcare system,” Anna says. “We appreciate the end result, the life-saving technologies, but rarely acknowledge the 15 iterations of prototypes that were developed to get there.” She notes, for example, the balloon catheter, prototyped by Dr. Andreas Gruentzig on his kitchen counter in Switzerland, which led to the development of the interventional radiology department at Emory University. The technology and technique spread and today treats 500,000 people in the US each year.

“Our MIT lab was in the field looking for user innovators in hospitals around the world,” she says, adding that what they found, instead, was that “stealth health makers” were the ones adding the most value to the healthcare system.

“We found stealth medical making in hospitals all over… a stethoscope repaired with overhead transparencies, custom phototherapy masks for NICU patients and a DIY ambulance to transport patients in remote areas,” Anna tells us, noting that “healthcare is better when everyone is empowered to create devices.”

Humanizing Our Healthcare System

It’s difficult to imagine a business more delicate and intimate than healthcare. Yet the reality in today’s corporate hospital world is that many patients feel deeply disconnected and uncared for in a system that often feels aloof, cold and impersonal. The problem is not simple, nor is there a single solution. This daunting challenge is being seriously addressed in the medical world by two champions working to humanize healthcare from the inside—and we’re honored that they’re joining us at TEDMED 2015.

Thomas Lee, Chief Medical Officer for Press Ganey

Thomas Lee, Chief Medical Officer for Press Ganey

One such champion is the quality care pioneer Thomas Lee, who serves as the Chief Medical Officer for Press Ganey, where he leads development of strategies for measuring and improving quality of care. Tom claims that a key healthcare makeover requires recognizing physicians’ empathy as a business asset, and designating patient suffering an avoidable outcome.

Patient experience is an integral quality indicator at Press Ganey, but Tom’s commitment to the concept doesn’t just come from his leadership role there. As a practicing internist/cardiologist at Brigham and Women’s Hospital, Tom recalls how it felt to walk the halls in the wake of the 2013 Boston Marathon bombings. “I saw how everyone, down to the custodial staff, took tremendous pride in the work that they had done to save so many lives,” Tom says. “That experience helped me realize that pride and shame were motivators that greatly exceeded financial incentives in their potential to drive improvement in healthcare,” he shares.

Medical progress has produced “marvelous benefits,” Tom notes, but it “also has side effects – chaos, because there is so much to do, so many people involved, no one with all the information, and no one with full accountability. We focus on financial issues in healthcare all the time, but the bigger challenge is bringing organization to the chaos, so that we can improve quality, efficiency, and safety.”

Those same themes – quality, efficiency and safety – fuel the digital revolution in healthcare. However, this effort doesn’t always work out so well. Renowned UCSF internist, founder of the hospitalist movement, and former chair of the American Board of Internal Medicine, Bob Wachter, tells us that “Healthcare’s digital revolution is making some things better, some worse.”

Bob Wachter, Renowned UCSF internist, founder of the hospitalist movement, and former chair of the American Board of Internal Medicine

Bob Wachter, UCSF internist and founder of the hospitalist movement

Bob values the advancement of “the appreciation in healthcare, over the past 15 years that the outcomes of patients is at least as dependent on the quality of the healthcare system as on the smarts/commitment of the physician. I learned nothing of this paradigm in medical school, yet it now is central to my own career and the way we train future generations of physicians.”

Bob proposes that our “healthcare system needs to deliver better, safer, more satisfying care at a lower cost” and points out that “the only way we’ll make that happen is through use of technology.” Still, “our implementation of technology, to date, has been disappointing. I’m trying to break through the hype to allow us to understand how to implement technology tools so as to improve healthcare value and unlock the potential to improve health.”

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.

TMIcon

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.

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.