Apart from Desire – Q&A with Heather Raffo

Actor, playwright, and librettist Heather Raffo performed a powerful excerpt from her one-woman show, 9 Parts of Desire. We reached out to learn more about her inspirations, aspirations and ambition.

Heather Raffo performs on the TEDMED stage. [Sandy Huffaker]

Heather Raffo performs on the TEDMED stage. [Sandy Huffaker]

 

What motivated you to perform at TEDMED?

As an artist with Iraqi and American heritage, I most wanted to launch a conversation about how we recover from war: how we survive as individuals, families, cultures and countries.

My work grapples with an ever shifting identity of what it means to be Iraqi or American and how trauma changes one’s sense of self.   I was thrilled to have an opportunity to talk and learn from such diverse and profound thinkers and health care professionals about how they relate trauma and loss to survival and healing.

Why does this performance matter now? What impact do you hope the performance will have?

A few months ago I had a revelatory conversation with a US Military General. He reminded me that the effects of the wars in Afghanistan and Iraq have only begun to surface for our veterans. For Iraqis, the civilian population has experienced multiple traumas over multiple decades, the sense of belonging that once held that society together is shifting rapidly as it is throughout the Middle East.

The work I do tackles some of the most difficult conversations our nation has yet to have.   It also tackles taboos rarely addressed in Middle Eastern society.  It broadens the lens through which many view the Iraq war, and helps offer a complex understanding of those affected by violence.

What kind of meaningful or surprising connections did you make at TEDMED?  

I connected with so many extraordinary individuals at TEDMED.   But perhaps most moving, were the conversations I had with war veterans who sought me out after my performances. They were thankful that hard truths were used to break open subjects they feel have not been discussed openly. TEDMED was a unique environment to have those difficult conversations about devastating human experiences and the universal will to live.

What is the legacy you want to leave?

I’ve spent the last decades of my life devoted to bridging my Eastern and Western cultures – bringing the worst of war into a sacred artistic experience. The legacy I am working to bring about is a movement that uplifts the feminine experience, that addresses our relationship to violence and that integrates the Middle Eastern voice into the American theatrical canon.

What’s next for you?

I’m working on an adaptation of Ibsen’s A Doll’s House set in a Arab American family.  What is particularly thrilling about this work is that my writing is being done from an embedded position within Middle Eastern American communities.  The first mounted workshop will be at Georgetown’s Davis Performing Arts Center in December 2015.

I’m launching my Places of Pilgrimage monologue series on the web.  Middle Eastern women telling their stories in their own words! It is based on a writing workshop I developed for universities and community centers both in America and internationally.

My opera Fallujah, inspired by the life of US Marine Christian Ellis, will have its world premiere at Long Beach Opera in January of 2016. The opera is composed by Tobin Stokes.

Once these three projects are up and running, links will be available on my website heatherraffo.com.

A new vision for the future of telemedicine: Q&A with Elliot Swart

In his TEDMED talk, Elliot Swart directed our focus to telemedicine and its potential to not only replace but improve upon current diagnostic procedures.  We reached out to learn more about how he is shaping the future of telemedicine.

Elliot Swart takes the TEDMED stage. [Kevosk Djansezian]

Elliot Swart takes the TEDMED stage. [Kevosk Djansezian]

 

What advice would you give to other aspiring innovators and entrepreneurs?

One piece of advice I took to heart is set out to solve a problem that you truly understand. And even once you have a problem, don’t quit your day job until you have a real idea of how to solve it and why your solution is different. The most unhappy entrepreneurs I know are the ones who decided to be entrepreneurs before they had a problem to solve.

Now, I’m not suggesting you should wait around until lightning strikes. My favorite TED talk of all time is “How to start a movement” by Derek Silvers.  The gift I took away from that talk is that it takes a lot of people to truly accomplish something, and that being the second, third, or even tenth person to join is as important of a role as the person who starts it. There are hundreds of amazing startups and early stage companies solving meaningful problems. Go out and find one!

What has been your main source of inspiration that drives you to innovate?

My company, 3Derm, makes a teledermatology solution to help get melanoma patients seen sooner. In my work I’ve come across a number of people who will tell me about their friends or family who have died from skin cancer. I like cool technology as much as the next guy, but what really drives me is the number of lives we’ll save if we succeed.

Why does your talk matter now? What do you hope people learn from your talk?

Telemedicine is still seen as the second best alternative – standard practice only if the patient is extremely remote or has no other options. But, slowly, we’ve seen people start to turn the corner and realize that telemedicine can be used to lower costs and increase convenience in almost any population. By developing telemedicine systems for different specialties, we are essentially distilling the diagnostic process into the necessary information, making medicine more quantitative and easier to standardize.

My company has spent four years creating a telemedicine sense for dermatology. There are many other specialties that will require years of university research and commercialization. I hope my talk can convince people of telemedicine’s potential as a standard of care and the importance of pursuing this research.

Now is the time to face the truth about drug use – Q&A with Carl Hart

In his TEDMED talk, Carl Hart offered a highly provocative but evidence based view of drug addiction and its links with crime. Carl speaks from personal experience; he grew up in a poor neighborhood in Miami, where he himself engaged in petty crime and drug use. Today, Carl is an Associate Professor of Psychiatry and Psychology at Columbia University, and a self-professed advocate for social justice and science.  

"I was unprepared for what I would learn as I went about making my contribution to the study of the neurobiology of addiction." - Carl Hart, TEDMED 2014 [Photo: Kevosk Djansezian]

“I was unprepared for what I would learn as I went about making my contribution to the study of the neurobiology of addiction.” – Carl Hart, TEDMED 2014 [Photo: Kevosk Djansezian]

 

We reached out to Carl to learn more about why his talk is particularly timely today. Here was his response:

Today – May 19 –  would have been Malcolm X’s 90th birthday, had he not been assassinated fifty years ago. Malcolm X’s influence on human rights, social justice activists, and me is increasingly apparent as society becomes more concerned about issues of over-policing in certain communities. My TEDMED talk, “Let’s quit abusing drug users,” is particularly important today because it illustrates the detrimental impact of aggressive selective drug law enforcement on communities of color.

In recent months, the issue of hostile, militarized policing has been pushed to the national forefront in response to the killing of the black, unarmed teenager, Michael Brown, by a white police officer in Ferguson, MO. Similar types of killings have occurred too often under the guise of the war on drugs. Eric Garner, Ramarley Graham, Kathryn Johnston, Trayvon Martin, and Tarika Wilson are just a few examples. In all of these cases, authorities suspected that the deceased individual was either intoxicated from or selling an illicit substance. This talk shows that dangers of drugs have been exaggerated, and that this has helped to created an environment where unjustified police killings are more likely to occur.

The importance of my talk is even further enhanced because too many people misattribute societal ills to drug problems. For example, the majority of people who use drugs – 80-90% – don’t have a drug problem. They are responsible members of our society. They are employed; they pay their taxes; they take care of their families; and in some cases, they even become President of the United States. Our three most recent Presidents all reported using illegal drugs when they were younger. In my talk, I clearly show that the real problems faced by society are not drugs but are poverty, unemployment, ignorance and the dismissal of science that surrounds drugs.

In my TEDMED talk, I also present intriguing results from my own research, during which we brought crack users into the laboratory and offered them $5 cash, or a hit of crack worth more than $5. We repeated this many times with each person over several days in the laboratory.  The drug users chose the drug about half of the time, and the $5 the other half. Even a nominal amount of money was enough to deter them from taking the drug at least half of the time. These findings are inconsistent with the notion that crack users display the insane, “anything for a hit” behavior that I had been previously taught. They also demonstrate how attractive alternatives, such as viable economic opportunities, can go a long way in decreasing societal problems, including drug abuse.

Watch Carl’s TEDMED 2014 talk, “Let’s quit abusing drug users,” here:

 

Can Consumers Change the Business of Health Insurance? – Hangout Participants Address Remaining Questions

On April 30, a multi-disciplinary panel of experts joined us for a Great Challenges live online event to examine health insurance’s shift from a business-to-business industry to a business-to-consumer one. Moderated by USA TODAY’­s healthcare policy reporter, Jayne O’Donnell, the group discussed what is working, what’s not, and what it all means for businesses, for consumers – and ultimately – for healthcare costs. If you were unable to join us, check out the recast below:

We had so many important questions that our participants were unfortunately unable to adequately address each during our one-hour event. We gathered our unanswered questions and posed them to our participants so that they could continue the conversation off-air. Here’s what Jennifer Sclar and Abir Sen had to say:

How does a person’s gender, race, age, or socioeconomic status affect the likelihood that they will take on the consumer role in insurance purchasing?

Jennifer: The likelihood that people will have to take on the consumer role in insurance purchasing will largely be dictated by forces beyond their control.  It is a role that people will increasingly be forced into, either because of the insurance mandate or because their employer is moving to a defined contribution model and away from a defined benefit model.  However, there are enormous differences among groups in terms of where they will shop for insurance, how they will shop for insurance, and how successful they will be in terms of procuring the best product for the best price.  There are issues and differences among groups that we know about and that we can use to try to maximize engagement across the board.

With respect to gender, we know that the overwhelming majority of health decisions are made by women.  Women are far more likely to select an insurance plan for their family, make doctor’s appointments and treatment decisions for themselves and their families (including their children and their parents), and deal with insurance company billing and eligibility issues.  With respect to race and ethnicity, we know that the States and the federal government have been far less successful in their efforts to reach out to minorities, and Hispanics in particular, than other uninsured groups, and this is a serious problem that needs to be addressed.  With respect to socioeconomic status, we know that the ability to pay for insurance, even when it is heavily subsidized, is a huge barrier to entry for many uninsured groups.  And, finally, we know that the older and sicker you are, the more likely you will be to sign up for insurance and that the long-term health of any insurance marketplace will depend on the ratio of older/sicker enrollees to young invincibles.  Successful strategies to address the particular barriers to entry for each group will be imperative to the success of the ACA, as well as the long-term trend toward the consumerization of health care.

What impact will more patients taking control of their insurance purchases and having “skin in the game” have on healthcare costs?

Jennifer: Complicated plan design and increased cost sharing will lead to demand for greater price transparency and clearer billing practices.  Patients will demand to know what they are being charged for, and the underlying costs.  This will likely lead to greater competition and lower prices for routine care, but could result in higher prices for more complicated procedures.

Abir: That’s difficult to answer without accounting for all the other variables — the overall health of the population, the advances that are being made in medical technology, and whether the advances increase or decrease overall cost, to name a few. If all of those variables are held constant, I would expect that consumers having more skin in the game would reduce healthcare costs due to the consumer making better decisions (such as getting generic substitutions over brand name drugs where possible, going to urgent care versus ER, and getting more preventive care).

Several of you have products that allow for plan comparisons. But what resources exist for people to learn basic concepts of health insurance?

Jennifer: Most plan comparison tools offer consumers basic definitions of key insurance concepts.  The problem for most consumers, including those who are highly educated, is that they are not really interested in learning about health insurance.  Most consumers just want to know that they will have the coverage they want, when they need it.  Health insurance is a very complicated financial product.  Clear Health Analytics tries to strike a balance between the few who will want to have a deeper understanding of insurance, and the majority who want to know what they are buying (e.g. Will my doctor be in network? Are my meds covered? Can I see a mental health professional?), and what it will cost.  We offer more in-depth information in pop-up boxes, which allows the screen to remain relatively clean and uncluttered.  Consumers can also visit healthcare.gov and the State Based Marketplaces to learn more about health insurance; they can also consult a navigator, assister or an insurance broker.

Abir: A well-designed product will obviate the need for people to understand the nits and nats of health insurance. In 2015, you don’t need to be able to code in order to use a computer. In the 1970’s, you did. The computer industry developed user interfaces that allowed the layperson to use their product quite easily. With the advent of consumerization, a similar evolution will happen in healthcare. Now, the interface may not be solely internet-based — it may incorporate human components through phone, chat and even in-person meetings. We don’t know exactly what that looks like yet. We do know that a user-friendly interface must and will develop.

With patients rather than businesses as consumers, insurance companies will likely need to change the way they do business. What will that look like?

Abir: As individuals become more accountable for their health care costs, they are also going to start holding the entities that provide them healthcare services more accountable. This includes insurers, providers, administrators, and so on. The pressure from consumers and the dynamic of competition will force everyone to up their game or risk losing the consumer’s business! All of this will have a positive impact on product design and customer service. Insurance companies will need to create products that people actually want to buy. Providers will have to incorporate technology to improve the consumer experience. As everybody focuses on making the consumer happy, we will truly get a consumer-centric system.

As an aside, we need to stop thinking about and referring to consumers in the healthcare industry as “patients.” It’s like calling everyone who purchases auto insurance an “accident victim.” This distinction is important because the way we think about consumers needs to incorporate both those who are actually sick and accessing healthcare, but also those who aren’t and are truly just buying insurance.

A few insurance companies (such as Florida Blue) have opened brick and mortar stores to sell plans and provide customer service in-person. Is this a trend you see taking off? Why or why not?  

Jennifer: This will be interesting to watch.  The medical loss ratio provisions of the ACA have made brokerage commissions increasingly unaffordable for insurance companies.  Commissions are characterized as administrative overhead, which means they must come out of the 15-20% of premium dollars that insurance companies are permitted to spend on administrative expenses.  Insurance companies are looking for creative ways to cut administrative costs, and brokerage commissions are an easy target. Moreover, many insurance companies are eager to get into the private marketplace space.  The marketplace will change many long-standing arrangements in the health insurance industry, including those among insurance companies and brokers, and those among brokers and consumers.

Abir: There is a reason why airlines don’t have brick and mortar retail stores. When people buy plane tickets, they usually want to compare across various airlines and see which one is cheapest and/or most convenient. Likewise, in a consumer driven market, individuals will want to compare across several insurance companies and find a plan that suits them the best. It doesn’t make sense for them to go to a store where they can only get plans from one insurer, being sold by that very insurer.

Each insurance policy has unique coverage constraints, co-pays, agreements with pharmacies, etc. How would you counsel a health insurance consumer to be a savvy shopper when it comes to doctors, hospitals and pharmacies so that they’re paying the least but still getting excellent care?

Jennifer: This is where access to data and innovative technology can really help consumers.  Clear Health Analytics, as well as others, have created – and will continue to create – cutting-edge technologies that can help consumers evaluate costs, availability of preferred doctors, facilities and prescriptions.  One of the major changes that the ACA brought was the elimination of underwriting for health insurance.  This makes health insurance ripe for a major change in the way it is distributed.  Brokers are no longer evaluating consumers for risk – it is merely a matter of matching the right consumer with the right policy, and that is a task that is uniquely suited for an amazing technology platform.  Beyond the insurance purchasing decision, Clear Health Analytics wants to help consumers use their insurance by offering information on treatment options, costs, outcomes, and quality.

Abir: 
I would advise them to get an advisor who is independent, who doesn’t work for their employer, who doesn’t work for their insurance company, and has no financial conflict. Come to Gravie.com – we are open for business!

 

Making a living with biology – Q&A with Nina Tandon

At TEDMED 2014, Nina Tandon invited us into a world of bio-curiosity, urging us to explore the range of possibilities that come alive when we use biology as a tool to innovate.  We got in touch with her to learn more about what inspires her work, and what she hopes to achieve.

"Isn’t it exciting to think that the third industrial revolution could be about life?" - Nina Tandon, TEDMED 2014 [Photo: Jerod Harris]

“Isn’t it exciting to think that the third industrial revolution could be about life?” – Nina Tandon, TEDMED 2014 [Photo: Jerod Harris]

 

What advice would you give to other aspiring innovators and entrepreneurs?

I hope they learn that life itself is an entrepreneurial journey – it’s not a mystery! I remember, back in 2008, people kept on asking me if I was worried about finding a job.  I told them “I’m not worried about finding a job. I’m worried about the job I’m going to create!”  If you think like an entrepreneur, you are never going to be out of work, because you’re always going to be creating.  We live in an age when we should always be looking for opportunities, rather than simply waiting for them to be handed to us.  Science is evolving.  There isn’t a lack of opportunity – it’s just that they now take a different form.  They can be public/private partnerships, or academic/industrial partnerships.  If you think entrepreneurially, you’ll create your own opportunities.

Who or what has been your main source of inspiration that drives you to innovate?

The body is a miracle that many of us take for granted – I am continually inspired by its magic! I think the thing about the body that I am most fascinated by is that it’s so robust.  That robustness is what makes it difficult to study; we’re so busy trying to figure out how to generate data, and we’re looking for linearities within a nonlinear system. Our bodies don’t just have one solution to a problem – there can be tens of them.  That’s why, when biology fails, it fails spectacularly.

Why does your talk matter now? What do you hope people learn from your talk?

I hope that people realize that there is huge potential to meet sustainability challenges by viewing biology as a technology partner. We need to take biology off its miraculous pedestal, and ask how it might be possible to utilize it in our work.  That’s a powerful question that so many people are beginning to ask, from the most unexpected fields.  I want people to realize that biology is breathing into their lives.  People should walk around thinking “I might not be a biologist, but I should be because my field is about to be disrupted by it.”

What is the legacy you want your work and/or your talk to leave?

I hope that people will be inspired to care for their own “biological houses” as well as to take action to learn more about science. My hope is that increased appreciation for nature will inspire a new generation of activists and bio-innovators.  I don’t want to leave my stamp on anybody.  I want people to discover their own legacy, their own beauty and potential. I hope people forget all about me – it should be about them, not me.

Check out Nina’s TEDMED 2014 talk, “Borrowing from Nature’s Living Library”:

Exploring the arc of innovation – Q&A with Thomas Goetz

At TEDMED 2014, Thomas Goetz, health journalist, science writer, and entrepreneur, shared a riveting story about one of the lesser-known heroes of medical research whose successes carried crucial implications for future health discoveries. Curious to learn more, we reached out to him with questions.

"Science is not about that first moment - it's about the rules and the process that we use to explore ideas." - Thomas Goetz, TEDMED 2014 [Photo: Jerod Harris]

“Science is not about that first moment – it’s about the rules and the process that we use to explore ideas.” – Thomas Goetz, TEDMED 2014 [Photo: Jerod Harris]

 

What motivated you to speak at TEDMED?

I spoke at TEDMED in 2010, and giving that talk had a profound impact on my work and my career. I knew that, given the chance, this was an invitation I couldn’t turn down!

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

“Innovation” is such a buzzword these days. Everyone wants to be an innovator, every organization feels compelled to be innovative. The word smacks of shiny technologies and slick strategies; it seems almost a facile topic. But innovation – true innovation – is hardly easy. It’s a struggle of ego and conflict and rife with failure. Most of all, it’s hard work.

To me, the story of Robert Koch’s scientific efforts shows that Koch was innovating on two levels at once. The first was science, with the investigations into the germ theory. But, just as difficult was the fact that he had to invent a process. He had to devise a rule set that allowed the pursuit of discovery, what we know now as “in vitro science.” This process, which we take for granted today, is received knowledge. It’s important to recognize that the process is as much a thing as the result of the process. What’s more, we’re in the midst of a new area of innovation today – the idea of “in vitae science,” which I discuss in my talk. My hope is that people will see that creating the rules that govern this new kind of science are as much for the making as the laboratory science of the 19th century. And, it could be just as impactful.

What’s next for you?

At my startup Iodine, we are actively trying to build the rules and technologies that might allow in vitae science to flourish. By giving people a forum to share their medical histories and creating a new dataset that can help drive better decisions for others, we are providing a quantitative assessment of subjective experience. It’s very much continuing what I spoke about at TEDMED, and putting these ideas into real life.

Genome sequencing – is it for everyone? Q&A with Amy McGuire

At TEDMED 2014, Amy McGuire, Leon Jaworski Professor of Biomedical Ethics and Director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine, made us think twice about the unintended consequences of getting our genomes sequenced. We reached out to her learn more.

"You all know this, but it is worth stating the obvious: genomic sequencing is not an infallible prophecy of our future." - Amy McGuire [Photo by Jerod Harris, TEDMED 2014]

“You all know this, but it is worth stating the obvious: genomic sequencing is not an infallible prophecy of our future.” – Amy McGuire [Photo by Jerod Harris, TEDMED 2014]

 

What motivated you to speak at TEDMED?

I have seen many TED and TEDMED talks over the years, and have always found them to be incredibly thought-provoking and inspiring. To be honest, at first I was a bit intimidated to give a TEDMED talk. I questioned whether my story was worth telling to such a large audience, and I worried about stepping outside my comfort zone of a typical academic lecture to explore the more personal and humanistic side of my work. However, I feel very passionately about how our ability to learn increasingly more about our biological make-up through new genomic technologies influences how we think about the more existential question of who we really are. Giving a TEDMED talk allowed me to explore this question for myself and, I hope, to initiate a more public dialogue on this topic.

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

A complete draft of the human genome was published less than 15 years ago. It took 13 years and $3 billion to complete the Human Genome Project. Today, individuals can have their genome sequenced for just a few thousand dollars. For many, genome sequencing can provide important information to help diagnose and treat disease. Others are interested in having their genome sequenced because they want to know their future risk of disease. As genome sequencing becomes more widely available, individuals will need to make informed decisions about whether or not they want this information. I hope that this talk will help others understand the benefits and limitation of genomic sequencing and help make more reflective and informed decisions about obtaining their own genomic information.

What kind of meaningful or surprising connections did you make at TEDMED?

The most meaningful connection I made at TEDMED was with a delegate whose children are suffering from a rare undiagnosed genetic condition. They are very sick and she had been talking to researchers and physicians all over the United States about trying to get their genomes sequenced. After hearing my talk, she sought my help and I was able to connect her with my colleagues at Baylor College of Medicine who agreed to sequence her children’s genomes. While talking with her, it became clear just how difficult the diagnostic odyssey with her children has been. I am not sure if the genome sequencing will provide her with the answers she is looking for, but it meant a lot to me to hear her story and to be able to help her make the connections she was looking for.

3 Deadly Myths That Masqueraded as Knowledge in Women’s Health

by Betsy NabelPresident of Brigham and Women’s Hospital and Harvard Medical School professor.

Knowledge in science is something we never fully grasp because it is continually reshaped by new information. Information – such as the fact that women and men are different, from cells to selves – doesn’t change. Information is bounded in certainty. But we are at a particular disadvantage when the information that serves as the foundation of our limited knowledge is itself shaky. In the case of women’s health, myth and misinformation have been rampant and deadly.

Women's health leader Betsy Nabel at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED].

“Humility is the secret ingredient that unveils truth.” Women’s health leader Betsy Nabel at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED].

No myth has been more pernicious, or has cost as many lives, as the one that might easily have killed a patient of my own. It was 1983, and I was a young, hotshot cardiology resident, who of course, “knew everything.”  One night, a 32-year-old woman arrived in the emergency room where I worked. She described vague symptoms: aches, fatigue, a low-grade fever – nothing terribly specific. I ran some tests, didn’t find anything telling, and sent her home with Tylenol.  Two days later she came back with a full-blown heart attack.

The problem was, I knew that was impossible. I had been trained by the best, and the best had taught me what the best had taught them: Heart disease was a man’s disease, and the primary symptom of heart attacks was chest pain, which my patient did not have.

Thank goodness, that woman survived.  Her case has driven my career-long commitment to understand the difference between men and women’s health, and to raise awareness of women’s heart health in particular. Today we know not merely that women die of heart attacks, but, crucially, that women experience an entirely different profile of symptoms than men do.

In that case, we simply didn’t know what we were certain we did know. The same was true of a second myth that scarred women’s health for quite some time: that hormone replacement therapy improved women’s health. The model was simple: as women enter menopause, estrogen levels drop, and health problems ensue. The solution seemed intuitive and logical: replace the estrogen.

For years, the medical community relied on dogma — received knowledge — that these treatments worked.  Two in five menopausal or post-menopausal women received hormone replacement, in part to prevent heart disease.

But then scientists challenged the known, by putting this “knowledge” to the test. A multiyear, multimillion-dollar study by the National Institutes of Health – the Women’s Health Initiative (which is the brainchild of then-NIH Director Dr. Bernadette Healy) – examined more than 160,000 women and made a startling discovery. Not only did hormone replacement therapy not prevent heart disease; it actually caused it.

That visionary study — undertaken, significantly, by the public sector at sustained public expense — has saved countless women’s lives.

Today, a third myth is killing women, and this one remains enshrouded in misinformation. Just like we used to think heart disease was a man’s disease, today we think of breast cancer as the most important women’s cancer. Of course, in many ways it is. But lung cancer kills more women than any other cancer — nearly 200 every day, most within a year of diagnosis.

Yet, perhaps because of the stigma associated with lung cancer stemming from an inaccurate perception that the only way to get lung cancer is to smoke – which is especially wrong when it comes to women — research in this disease is chronically under-funded, especially measured by the harm it causes to individuals and families.

Women who have never smoked appear to be at greater risk of developing lung cancer than men who have never smoked. Of the 20,000-25,000 nonsmokers diagnosed with the disease each year, more than 60 percent are women.  Women also develop lung cancer at an earlier age than men. Yet, unlike breast and prostate cancer, for example, there is no widely accepted screening test for lung cancer.

Lung cancer thus presents a double myth: first, that it is solely a smoker’s disease; and second, that it is a cancer women don’t need to worry about.

These myths are a compelling reminder of the need for researchers and clinicians alike to treat men and women as what common sense tells us they are: different. That means clinical trials need to impose a gender lens at every stage of discovery and explore the unique effects of diseases and therapies on women as well as on men, which will lead to better health for both sexes.

An oft-shunned word, ignorance, carries great importance when we consider it as the driver of scientific inquiry, and thus, the molder of new knowledge. Yet when myths are widely believed to be facts, ignorance can kill. We owe half the world’s population much more than that.

Elizabeth Nabel, the President of Brigham and Women’s Hospital and a professor at Harvard Medical School, shared a personally revealing story on the TEDMED stage that pointed to how the limits of knowledge can be a weakness and how accepting our ignorance can be a strength. We are honored she has written an original piece for the TEDMED blog.

An Emerging Era of Vitalized Electricity: Q&A with Mark Levatich

At TEDMED 2014, Mark Levatich urged us to imagine the possibilities of a world vivified by electricity. Inspired by his enthusiasm, we reached out to him with questions about his talk, and any tips he has for young innovators.

"Electricity should be boring by now, but waves of revolution ripple up from initially small innovation to consume and transform our world.  Why, when we see the timeline, and the consistency of change, could we ever think the wonder is done?" - Mark Levatich at TEDMED 2014 [Photo: Kevork Djansezian]

“Electricity should be boring by now, but waves of revolution ripple up from initially small innovation to consume and transform our world. Why, when we see the timeline, and the consistency of change, could we ever think the wonder is done?” – Mark Levatich at TEDMED 2014 [Photo: Kevork Djansezian]

 

Why does your talk matter now? What do you hope people learn?

I knew my great-grandfather; he fought in WWI on horseback, and later lived in a household full of Apple products. We can imagine the transition of living in his world and expect the same scale of change in ours. The advances may not look rapid but we’re still rehashing the same tools of computers and programs. Leaps that challenge our imagination arise from fundamentally different abilities. That is why shape-changing plastic is primed to alter the course of human history. It can solve hundreds of existing problems, in unexpected, previously impossible ways. It also solves problems we didn’t recognize without an obvious solution. Nearly living plastic won’t be the final surprise during our lifetimes, but it’s primed to be the next.

In my talk, I described living plastic enhancing heart surgery, but I could have focused on braille, or keyboards, mice, drones, camera lenses, hearing aids, band-aid insulin pumps, capacitive batteries, bullet-sized tasers, electro-caloric heat sinks, ultrasonic tape, or woven sensors in clothes. The technology is already functional, but will see centuries of rehashing to creatively morph our world. It matters now because it will happen soon. It matters now because the pace of change is becoming mind-boggling, even for those of us now who are accustomed to surprise.

What advice would you give to other aspiring innovators and entrepreneurs?

If you are a young innovator, protect your naiveté and practice inception. As a budding innovator, you may find mentors and peers willing to help. I am sorry that their advice may be your greatest early challenge.

Any new skill takes repetition to master. Innovation by its nature should always yield conflicts with existing knowledge. To learn from a mentor’s advice, you must repeatedly sacrifice ideas. The sacrifice is active. It’s more than presenting concepts for appraisal. Ask your subject to share what their thoughts were just prior to their objection. Decipher the types of mental connections they used to crunch your idea, rather than source material. Meditating through and duplicating their thought process will permit you to absorb the strongest mental tools they have demonstrated. Repeating this process with diverse and accomplished people will allow you to compound the strengths of your mentors. In the end, the most important outcome is protecting your willingness to re-engage in deconstruction. Your naiveté makes your ideas vulnerable to overcorrection, and you must resist the social shock and keep practicing.

You may be presented with a plethora of unseen obstacles, a weakness of founding knowledge, an unrealistic sense of time, challenge, or concept placement in the existing landscape. All of these are irrelevant. The quality of your ideas matters only when you are primed to strike out and implement. Until that time comes, your goal should be to propose endless concepts. Exercise, through repetition, the mechanics of inception. The plentiful resource of criticism is not a crucible for your sword of conquest; it is, in fact, the hammer you wield to pound your innovation into shape.

The Promise of Personalized Medicine: Q&A with Gary Conkright

At TEDMED 2014, PhysIQ CEO Gary Conkright shared his perspective of how personalized, quantified health data is vital to preventing disease.  PhysIQ was recently selected to collaborate with USAID in their efforts to use such techniques to potentially control the spread of Ebola.  We reached out to Gary to learn more.

"Today, we’re on the verge of the next transformation in healthcare: Quantitative Medicine 2.0" - Gary Conkright, TEDMED 2014 [Photo by Brett Hartman]

“Today, we’re on the verge of the next transformation in healthcare: Quantitative Medicine 2.0″ – Gary Conkright, TEDMED 2014 [Photo: Brett Hartman]

What is the legacy you want your talk to leave?

I hope that my talk inspires just one entrepreneur to think “outside the box” to innovate a new medical device or procedure, or one physician to dare to adopt a “non-traditional” medical approach to deliver the best care and help prevent a preventable illness.  Failure should not be an option.

Speaking of thinking outside the box, can you tell us more about the work you are doing to help combat the Ebola crisis?

In my TEDMED talk, I spoke about how the next transformation in healthcare is quantified, personalized medicine.  This involves the comparison of a person’s physiology to their own unique baseline instead of population-based norms, like 98.6 degrees for “normal” body temperature. It is now possible to build a personalized baseline and to detect subtle but very important changes in one’s physiology, thereby enabling an early clinical intervention.  Seeing the potential of this approach, The Scripps Translational Science Institute recently asked PhysIQ to work with them alongside USAID to help address the Ebola crisis in West Africa.

One of the reasons why Ebola is so difficult to contain is that once someone is infected with the virus, they become contagious well before any symptoms appear.  Currently, the best Ebola risk management protocol requires patients to self-manage by taking their temperature twice a day. However, as with many diseases or exacerbations, the human body’s natural defense and self-management system kicks in to fight this virus almost immediately to protect and sustain the body, and ultimately life. These defense mechanisms manifest themselves in changes of easily measured vital signs like heart rate, respiration rate and blood pressure.

However, these same vital signs normally vary quite dramatically throughout the day as a person goes about their daily living.  For example, when asleep, a heart rate of 40 beats per minute could be considered “normal” as would a heart rate of 120 beats per minute after walking up a few flights of stairs, but someone’s heart rate can be “within the normal range” of 60-100 but still be a sign of physiologic decompensation if inappropriate in the context of other measured parameters.  These normal dynamic fluctuations can mask the subtle changes that are a direct result of the body’s defense response.

When we holistically compare these multiple key physiologic parameters to the person’s unique baseline, the expected or “normal” physiological response can be removed, leaving the abnormal response that is fighting the disease.  We will soon start field testing in West Africa to validate this approach, which – we hope – will work for any progressive disease where early detection can save lives.

What advice would you give to other aspiring innovators and entrepreneurs?

The mystique of entrepreneurship excites the human spirit, but bringing a disruptive innovation to market is very hard work, and not for the faint of heart.  The highs are exhilarating and the lows are harsh, and the cycle time between these two extremes is often very short.  But, for those who are passionate about making a difference, and who have the risk tolerance, emotional fortitude and – perhaps more importantly – the support of family, there is no better career option.