Brain in Progress: Why Teens Can’t Always Resist Temptation

by Nora Volkow, Director of the National Institute on Drug Abuse at the NIH

It’s National Drug Facts Week, when middle and high schools all over the country host events to raise awareness about drugs and addiction, with the help of scientists from the National Institute on Drug Abuse (NIDA). The issues I discussed in my TEDMED talk—the changes in the brain common to obesity and drug addiction—are especially pertinent to the struggles teens face to resist drugs, because adolescence is a crucial period both of susceptibility to the rewards of drugs and of vulnerability to the long-term effects of drug exposure.

“My obsession is to engage the health care system in addiction.” Nora Volkow on Nora Volkow at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED.]

“My obsession is to engage the health care system in addiction.” Nora Volkow at TEDMED 2014. [Photo: Sandy Huffaker for TEDMED.]

Adolescence is a time of major brain development—particularly the maturation of prefrontal cortical regions involved in self-control and the neural circuits linking these areas to the reward regions. The prefrontal cortex, where we make decisions and comparative judgments about the value of different courses of action, is crucial for regulating our behavior in the face of potential rewards like drugs and food. Adolescents are prone to risky behaviors and impulsive actions that provide instant gratification instead of eventual rewards.  In part, this is because their prefrontal cortex is still a work in progress.

The incomplete maturation of the prefrontal cortex is a major factor in why young people are so susceptible to abusing drugs, including alcohol, tobacco, marijuana, and prescription drugs. There are numerous pressures in their lives to try these substances (stress and peers, for example), but inadequate cognitive resources to help them resist. Because their brain architecture is still not fully developed, adolescents’ brains are more susceptible to being radically changed by drug use—often specifically by impeding the development of the very circuits that enable adults to say “later” … or “not at all” … to dangerous or unhealthy options. Thus, when drug abuse begins at a young age, it can become a particularly vicious cycle. Research shows that the earlier a teen first uses drugs, the likelier he or she is to become addicted to them or to become addicted to another substance later in life. It is likely that the same dynamics are at play when it comes to fattening food and the brain’s reaction to it.

Though parents may get frustrated by their teens’ poor decisions at times, they usually forgive them—because on some level adults understand that kids’ internal guidance systems aren’t yet fully functional. People often have a harder time extending that same forgiveness to adults who suffer from addictions or obesity, because we think they should be better able to control their impulses.  But, the fact is that their internal guidance systems, too, are compromised. For such individuals, it is not a question of free choice or just saying no to temptation; in many cases, only externally offered support and treatment can create the conditions in which their guidance systems can be gradually restored to proper working order.

Averting obesity and drug use also requires that, as a society, we take responsibility for the environments we create for young people. Instead of school cafeterias with an array of cheap, tempting foods high in calories and low in nutrients, we must expose young decision makers to food options that strengthen their health and resolve. Instead of stress-filled or empty time that promotes drug use, kids need access to appealing, healthy, and meaningful activities that encourage them to take pride in themselves and their behavior. Arming young people with scientific information about their bodies, brains, and the substances that can affect them is also crucial—which is the goal of National Drug Facts Week.

Obesity and drug abuse are medical issues, not moral failings. It is gratifying to present the converging science clearly showing this in a forum like TEDMED, composed of people who are informed and curious about the latest medical science. My hope is that the general public becomes more compassionate about these issues, supports wider access to treatment, and understands the importance of greater investment in research on the dynamic ways our brain can be changed by our behavior and vice versa.

Neuroscientist Nora Volkow, director of the National Institute on Drug Abuse at the NIH, applied a lens of addiction to the obesity epidemic in her TEDMED 2014 talk. We are excited to share Nora’s original piece on the TEDMED blog.

Join us Thursday, February 12 at 1pm ET for a live Facebook Chat with Nora to find out what we can learn about food addiction from studying the brain chemistry of people with drug addictions. Tweet your questions in advance using the hashtag #TEDMED.

Paging Dr. Salsa: Q&A with Gerardo Contino

Gerardo Contino, “El Abogado de la Salsa,” and former lead singer of the Cuban mega-group NG La Banda, invigorated the TEDMED 2014 audience with timba — a progressive, raucous style of salsa, with his band, Los Habañeros. We caught up with him to learn about his vision and impressions of TEDMED 2014 speakers.

Gerado Contino TEDMED 2014
Gerardo Contino y Los Habañeros on the TEDMED 2014 stage. Photo: Robert Benson for TEDMED.

What motivated you to perform at TEDMED?

I’ve understood the power of music to heal ever since I was nine years old and sitting at the bedside of my sister, who was diagnosed with an aggressive cancer at the age of 14. I’d sing to her and we’d play her favorite music tapes while she was recovering from surgery or chemotherapy. Music was the one thing that could make her smile during that time. After moving to the United States from Cuba, I began volunteering with a non-profit organization, Musicians On Call, where I sang at the bedside of sick children in order to provide them with some relief and variety. I wanted to share this power of music to heal with the TEDMED community.

What are the top three TEDMED 2014 talks or performances that left an impression with you?

Elizabeth Holmes (CEO, Theranos): Loved this talk because I really felt that they are revolutionizing science and the ways in which all of us as patients, can have access to our health information. It also made me think how useful this technology would have been for my sister when she was undergoing chemotherapy, as the doctors had difficulties finding her veins after a while.

Diana Nyad: This talk stood out to me and was so inspiring. She demonstrated that anything is possible at any age and this was very inspiring to me as an artist. She really demonstrated the saying, you can achieve whatever you set your mind to. And to top it all off, she was a great storyteller and really funny.

Tig Notaro: Tig’s talk really moved me. The fact that when she was at the height of her career, she was diagnosed with cancer and also underwent the personal dramas of losing her mother and breaking up with her partner, all in the span of a few months — that would take the life out of anyone. But instead, she turned it around and opened up to her audiences about what she was going through and used that as a form of not only coping with what was going on in her life, but also strengthening herself.

What is the legacy you want to leave?

A stronger community of Latino artists who are of Afro-Latin and indigenous backgrounds.

What’s next for you?

I’m releasing a new album in 2015 that includes a wider fusion of music, especially dedicated to mixing South American and Caribbean beats. I’m also developing a new project that will include an album and documentary about the various Afro roots of Latino music from African diaspora communities throughout the Americas. The album will feature fifteen songs from fifteen different communities throughout North, Central, and South America.

Sink or Swim, Do or Die: Q&A with Diana Nyad

Marathon swimmer Diana Nyad returned to the TEDMED stage in 2014 to share lessons of her world record-setting solo 110-mile swim from Cuba to Miami at age 64. We caught up with the open water swim champion about her TEDMED experience and what’s up next for her in 2015.

When you achieve your dreams, it’s not so much what you get, it’s who you become.” Diana Nyad on the TEDMED 2014 stage. Photo: Sandy Huffaker for TEDMED

What motivated you to speak at TEDMED 2014?

TEDMED 2010 was my first TED experience. The range and brilliance of the speakers blew my mind. These dedicated innovators are quite literally solving the medical mysteries of our time, and so I was both humbled and honored to appear on stage in their midst. It was a no-brainer to accept the 2014 invitation and to again mix in with our leading health and medical minds.

What kind of meaningful or surprising connections did you make at TEDMED 2014?

I found Marc Koska and his world-changing work with one-time-use syringes deeply moving. This is a classic tale of a man with a social conscience, determined to literally save millions of lives with plain determination. Thirty years ago, Marc was casually reading a magazine and it shocked him to his very core to learn how many millions of people worldwide either die of or are infected with horrific diseases, due to the use of contaminated syringes. He was shot down everywhere he went but eventually implemented the one-time-use needle that cannot be picked up and used to prick the skin a second time. Marc Koska is a shining example of both the work that TEDMED spotlights and those human beings who refuse to let humanity suffer when there are other choices.

How can we learn more about your upcoming book and one-woman show?

Knopf will publish my “Memoir of Inspiration” sometime in 2015. The world premiere of my one-woman show, “ONWARD!” will be on February 19022, 2015 at Studios Theater in Key West, FL and then we move to a bigger theater in Ft. Lauderdale the following weekend. We hope to develop the show for Broadway next!

A terrifying tale about over-prescribing: Q&A with Elizabeth Kenny

Actor and playwright Elizabeth Kenny performs an excerpt from her play dramatizing a horrifying journey through the American medical system during which she was over-prescribed psychiatric medications. We asked her a few questions to learn more about her experience and work.

A terrifying tale about over-prescribing: A performance by Elizabeth Kenny
Actor & playwright Elizabeth Kenny performs at TEDMED 2014. [Photo: Jerod Harris for TEDMED.]

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

In 2014, the top selling drug in America was an anti-psychotic called Abilify. Are there really that many people in need of anti-psychotics? I want an answer to this question. The pressure of marketing and the lack of time and true collaboration between patients and doctors are leading to a crisis of over-prescribing and medicalizing suffering of all kinds. I hear people talk about how great it is that more people have access to mental health care now more than ever before – how wonderful it is we have these “silver bullet” medications for debilitating states like depression. I want to be happy, too… but I’m scared. It seems to me that the help being offered is not always helpful. I’m afraid that if we don’t start a more rigorous and nuanced conversation about the health of our mental health system, in the long run, many more people will be harmed than helped. I hope this talk can be a starting place for some to enter the conversation. I think a great place to start would be with simple transparency about what we truly know and don’t know about the brain, and about how psychotropic medications work on it.

Is there anything else you wish you could have included in your talk?

My original play, Sick, was 70 minutes long, and editing it down to a 12 minute talk was an enormous intellectual and artistic challenge. Early on, I realized I would have to leave out the entire second half of the play which was all about withdrawal from the medications – a grueling process, and one that I almost didn’t survive. We were operating under a controversial hypothesis (that the medications I was taking might be making me sick) and we found tremendous resistance from inside the psychiatric community. Coming off psych meds is a deeply personal decision and not one that should be entered into lightly. Tapering very slowly made it possible for me. I suffered tremendously during the protracted eight months in which I tapered off of all my medications. I was very lucky to have my family’s support – physically, emotionally and financially. Getting off my meds became my full-time job; helping me became my mother’s full-time job.

What motivated you to speak at TEDMED?

I had been performing and touring with my play Sick for a couple years when I received the invitation to speak at TEDMED; the experience of making and taking the play on tour was so surprising. While I was living through the story, I was certain that what was happening to me was extreme, that I was one in a million, and that nobody else could possibly be going through the same thing. Once I started to perform and engage with audiences I was shocked by how many people wanted to talk after the show to share their stories. I have lost count of how many times I heard, “I think this is happening to my sister,” or mother, or aunt, or boyfriend. It has become clear to me that what I, my family, and my doctors thought was a rare occurrence may be far more common than any of us can fathom. I feel an obligation as both a writer/performer, and as a person who came through an iatrogenic mental illness, to raise questions. How many more people like me are there? How are people’s lives being subtly or not so subtly diminished by their treatment? Are we really operating within a system that allows for informed consent if all our drug information is coming from those who stand to profit from its sale? My role in transforming the mental health system is to ask questions and tell stories, and the TEDMED stage seemed like a perfect fit.

Check out the archive of our lively Facebook chat with Elizabeth where we dove deeper into her story and reflected on audience members’ similar experiences. 

Beautifying Darkness: Q&A with Zsolt Bognár

Critically acclaimed concert pianist Zsolt Bognár, frequently featured on NPR, performed two pieces by Schubert and shared his story about how a special connection to Schubert brought him healing solace in part by beautifying darkness. For the TEDMED blog, Zsolt gave us insight into his process, his time at TEDMED and what’s next for him.

Beautifying Darkness - Concert Pianist Zsolt Bognar

Concert pianist Zsolt Bognár on the TEDMED 2014 stage. Photo: Jerod Harris for TEDMED.

What motivated you to perform at TEDMED?  

The TEDMED team contacted me and showed me instantly that this event would be about a gathering of many brilliant and inspiring minds, sharing many stories of innovation and courage. I wanted to share a story through my life and music that was very personal to me.

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

Lots of awareness is being raised these days about the importance of addressing mental health issues, including depression. My story concerns the way that I proactively dealt with my own depression through the inspirational story of Franz Shubert’s final year before his death at the age of 31.

What top three TEDMED 2014 talks or performances that left an impression with you, and why?

Kitra Cahana moved me to tears. She told a story of courage and finding freedom in the face of incredible adversity, and shared her story through images of striking beauty. My other favorite was Tiffany Shlain. Her multimedia presentation capturing the interaction of people and minds was stunning. Elizabeth Kenny‘s performance was dynamic and gripping.

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

People from all around the world came to me telling me their love of music had been reignited, and that some even plan to restart piano lessons.

What is the legacy you want to leave?

My life has been enriched by being open about the challenges I have faced, and connecting with others about how I overcame them was a personal liberation. I hope that with my music, I can encourage others to find hope by doing the same.

What’s next for you?

I’m in Europe giving recitals around the holidays. In February, 2015, I will give a performance in Cleveland with the Verb Ballet in a set of pieces composed for the occasion by a local composer friend of mine, Philip Cucchiara. I have always loved to combine art forms. My tours in the upcoming year will take me several times to Europe. I will also continue creating episodes for my film series Living the Classical Life with many famous classical musicians from around the world. It’s a very beautiful experience and a wonderful privilege to share music.

Virtual Reality: Immerse yourself in health – Q&A with Howard Rose

In his TEDMED 2014 talk, game designer Howard Rose describes the extraordinary power of play in virtual worlds, and shares how virtual reality can harness the innate human power to recover from and prevent illness. We caught up with Howard to learn more about his TEDMED experience and what inspires his work.

Gaming, health, virtual reality, Howard Rose.

“The doctor-centered paradigm of healthcare underutilizes our innate human power to recover on our own, or to prevent illness in the first place.” Howard Rose, TEDMED2014. Photo: Sandy Huffaker for TEDMED.

What drives you to innovate?

For me, virtual reality (VR) is the ultimate creative medium. As a designer, I enjoy the challenge of transforming complex ideas into meaningful experiences that bring people insight and joy. Virtual worlds can range from being very realistic to a realm of total imagination. Because VR is so unconstrained, the design process invariably evokes challenging questions about the mind, body and senses that spark the creative conflict which drives innovation.

I’ve devoted my career to exploring the boundless possibilities of technology to solve real world problems, particularly problems in health. We are just beginning to discover how to apply VR to some of our toughest challenges to control pain, treat mental illness and improve rehabilitation.

Why does this talk matter now?

Virtual Reality is poised to revolutionize the way we maintain our health and deliver treatment. It will be targeted like a drug and deliver sustained benefits. But better than drugs, VR can be personalized to individuals’ needs on a moment-by-moment basis. VR will make us more resilient, able to perform at our highest capacity. This revolution will be driven by consumer demand.

Today we are at the edge of a wave of new virtual reality technology that costs a fraction of the systems I used 20 years ago. The VR revolution is amplified by advances in neuroscience and the expanding array of biosensors we wear and carry in our mobile devices. All the elements are finally here to deliver intelligent, compelling virtual experiences that know our strengths and weaknesses and respond to our needs. These technologies are going to help people stay healthier on a daily basis, and lead to new treatments for many conditions that today we suppress or control with pills – like pain, anxiety, depression, or post-traumatic stress.

What legacy do you want to leave?

I want to give people the tools to unlock their own potential to be happier, healthier and more productive. My goal is to make the virtual reality health games industry bigger than the entertainment game industry. I’ve been working toward that goal for 18 years at Firsthand Technology, laying the groundwork  with basic research and development.

I’m now part of a new venture, DeepStream VR, to focus on virtual reality games for pain relief, rehabilitation and resilience. DeepStream VR’s mission is to reduce the need for opioids in clinical practice, and provide new alternatives for people at home to relieve pain.

Games and Health: Q&A with Brian Primack

At TEDMED 2014, Brian Primack, Clinician, Professor, and Assistant Vice Chancellor of Research on Health and Society at the University of Pittsburgh School of Medicine, shed light on how principles learned from video game design can be used to create more effective health behavior change. We caught up with Brian to learn more about his work and his experience at TEDMED 2014.

How healthcare can learn from video games. Jerod Harris, TEDMED2014. Photo: Sandy Huffaker for TEDMED.

The video games industry is really good at getting people to perform certain tasks and to stick with them for the long haul.” Expert design including instant reward, social networks, and intermediate milestones can effectively improve patient outcomes. Photo: Jerod Harris for TEDMED.

Personally, what do you prefer: “old-school” video games, or the most recent technology? Why?

I prefer old-school video games. Part of it may be nostalgia. However, I also think that sometimes, simpler graphics and can translate into a richer imaginative experience. For example, I still sometimes play old Infocom games. Infocom created brilliant text-only interactive fiction games starting in the early 1980s.

Do you encourage your children to play video games?

My kids (ages 7 and 10) play video games, and I often play with them. Some of our favorites are logic, simulation, and/or physics games such as Civiballs, Meeblings, and Bloons Tower Defense. What I encourage even more than playing, however, is creating video games. Both of my kids can do basic programming on MIT’s Scratch platform and have created simple games of their own.

Beyond health and medicine, what other applications or fields do you see gamification having a large impact on?

Gamification may be very valuable in education. I think there is an important balance to be struck, though. I think it’s great to leverage the tools we have now to make learning more engaging. However, we also want to encourage people ultimately to learn for its own sake, not just because they are getting points or incentives. I don’t think these positions are mutually exclusive, but balance is important to think about as we develop new educational tools.

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

I really appreciated the opportunity to reconnect with some past colleagues; it was also invigorating to meet people whose work I had admired from afar. I caught up with Lee Sanders, MD, MPH, Chief of the Division of General Pediatrics at Stanford; he’s well-known for his work on promotion of child and family health via health literacy.

What’s next for you?

Our Center for Research on Media, Technology, and Health continues to research both the positive and negative influences of media and technology on health outcomes. We develop and test interventions to support positive attributes of media and technology while also buffering their potential negative influences.

Zoobiquitous Medicine: Q&A with Barbara Natterson-Horowitz

Barbara Natterson-Horowitz, Professor of Medicine in the Division of Cardiology at UCLA Medical School, offered an unusual perspective on how human patients, including those suffering from mental illnesses, can be helped by applying insights from animal health. We caught up with Barbara to learn more about how her Zoobiquity idea improves understanding of ourselves and the natural world.

Zoobiquitous Medicine. Barbara Natterson-Horowitz at TEDMED2014. Photo: Sandy Huffaker for TEDMED.
“When I see a human patient, I always ask, ‘What do the animal doctors know about this problem that I don’t know?’” Barbara Natterson-Horowitz at TEDMED2014. [Photo: Sandy Huffaker for TEDMED.]

What motivated you to speak at TEDMED?

After 20 years of practicing cardiology taking care of patients with heart attacks and high cholesterol, I was thrust into the world of veterinary medicine. Seeing my human patients as human-animal patients completely changed how I practice medicine and understand health and disease. Insights from this species-spanning approach to medicine can benefit human and animal practitioners and patients alike. It’s thrilling to introduce this approach to physicians, psychologists, dentists, nurses, etc. and watch their viewpoints transform; the exposure at TEDMED led to a collaboration between a celebrated human breast cancer physician studying a mutation that causes breast cancer in women with a veterinary oncologist working on the same mutation that causes breast cancer in jaguars and other animals!

Why does this talk matter now?

Animals and humans get basically the same diseases. From heart failure, diabetes and brain tumors to anxiety disorders and compulsions, the challenges we face aren’t uniquely human. Discovering why, where, and how non-human animals get sick reveals crucial but hidden clues to human health and illness. For instance:

Breast cancer: When beluga whales began dying of breast and colon cancer in the St. Lawrence estuary, a parallel epidemic of breast cancers in women was discovered in the same region. This species-spanning breast cancer outbreak was ultimately linked to toxins from local aluminum smelting plants.

Obesity: Medical insights into obesity — which challenges physicians and veterinarians alike as animal and human patients are becoming more fat — are generated by a zoobiquitous approach.  Awareness of worsening obesity in domestic and wild animal populations challenges us to consider environmental factors including endocrine disrupting chemicals,  antibiotics, and even climate change as contributors to the “plurality of obesity epidemics.”

Infectious disease: The majority of infections that could create human pandemics come from animal communities. From Ebola to West Nile Virus, SARS to H1N1, some of most worrisome threats to human health and survival are encountered first by veterinarians and animal experts. If we fail to pay attention to these experts and miss out on the opportunity to collaborate, we lose crucial information and increase unnecessary risk for human populations.

How do you see your work fitting into species-survival, wildlife preservation and conservation?

Zoobiquity emphasizes the interconnectedness of animal and human lives and ecosystems. Animals can be sentinels of disease in humans. When horses in Venezuela start to die, it can mean equine encephalitis may threaten local human populations. When cormorants and crows get sick with West Nile virus in Queens and the Bronx, elderly and immunocompromised patients may also be at risk for the virus. On the other hand, humans can be sentinels of disease in animals. Human outbreaks of Brucellosis often lead to identification of sick and suffering animals. The detection of lead poisoning in a child often leads to exposure and disease in local wildlife. Bringing practitioners of animal and human health together encourages the transfer of information from the world of human medicine that is vitally relevant and important to wild animal populations.

What do you hope for the legacy of Zoobiquity? 

Zoobiquity Conferences have now been held across the US and internationally. At these events human health practitioners including physicians, nurses, dentists, psychologists and others come together with animal health practitioners including veterinarians, behaviorists, nutritionists and others to discuss the shared diseases of their different species. I’ve heard some veterinarians joke, “real doctors take care of many species.” Bringing the comparative approach to the human medical community has the power to transform how physicians, nurses, psychotherapists and others understand disease, their patients and the environmental and evolutionary factors that link us all together.  I hope Zoobiquity is successful in bridging the worlds of animal and human health, ecology and evolutionary biology.

Check out our archived Facebook chat with Barbara about species-spanning medicine. 

What is Culinary Medicine? Q&A with John La Puma

Nutrition specialist, chef, author, and practicing physician John La Puma lives and works on an organic farm in California. He makes his garbanzo guacamole recipe on the TEDMED stage while sharing his philosophy that the food we eat is as important as the pills we take, a key component of preventive health and our well being.  On the TEDMED Blog, John elaborates on culinary medicine and what role patients may have taking charge of their health and even educating their physicians about how to consider nutrition as part of the treatment plan.

John La Puma on culinary medicine

“Food is the most important healthcare intervention we have against chronic disease.” John La Puma, TEDMED 2014. Photo: Jerod Harris for TEDMED.

Why does this talk matter now?

Patients who ask their doctors, “What should I eat for my condition?” really want answers. Meanwhile, clinicians are clamoring for more and better information and training on nutrition. Culinary medicine is a new evidence-based field in medicine that blends the art of food and cooking with the science of medicine to yield high-quality meals and beverages which aim to improve the patient’s condition. It is already being taught in both undergraduate and postgraduate medical education.

What impact do you hope the talk will have?

I hope that the talk will help accelerate the cultural shift in healthcare towards wellness and well-being as primary goals in medicine. People need to know that some physicians care deeply about helping them become well with what they eat.

What is the legacy you want to leave?

Our mission is to inspire health-conscious consumers to look, feel and actually be measurably healthier by what they eat. The opportunity to use culinary medicine to prevent and treat disease is substantial, and culinary medicine should be considered as part of both the medical history and treatment plan in medicine.

How would medicine change if your ideas become reality?

All clinicians should be able to write culinary medicine prescriptions and know how food, like medicine, works in the body. I’d like to see condition-specific food and lifestyle measures become something that clinicians can offer, effectively, before prescription medication for most chronic conditions.

What is your core belief about culinary medicine?

Everyone has a right to clean, healthful, delicious, real food that both satisfies their appetite and makes or keeps them well…before it may be too late to offer more than comfort food.

Please share anything else you wish you could have included in your talk.

70% of heart disease, stroke, diabetes, memory loss, premature wrinkling and impotence are preventable. 80% of cancers and much of asthma and lung disease are preventable, and from environmental causes, like toxin exposure or diet.*  Knowing more about what’s in your food and how it got there can help you take your own health into your own hands, save you money and provide joy and energy for those you love. With culinary medicine, health-conscious people can live life to its youngest.

Ask your doctor, “What do I eat for my condition?”  If he or she doesn’t know, do your own research- here’s my list of resources.

Now it’s time to try John’s Luscious & Rich Garbanzo Guacamole recipe!

1 ripe medium avocado, preferably Haas

1 medium clove of garlic, peeled, diced and creamed with lime zest

1 medium serrano chile pepper, stemmed and diced, but not seeded

1/4 teaspoon minced lime zest, preferably organic

2 tablespoons fresh lime juice (about 1 medium lime)

1 tablespoon extra virgin olive oil, COOC preferred

1/2 cup cooked chickpeas, rinsed and drained

1/2 teaspoon yellow curry powder, such as Madras curry

1/4 teaspoon black pepper

5 sturdy springs cilantro or Italian flat leaf parsley (optional)

Cut the avocado in half long-wise around the pit and separate the halves. Remove the pit.

Use a spoon to scoop around the flesh and remove it in one piece.

Place upside down on a cutting board, dice into large chunks. Scoop up and place in a large stainless steel bowl.

Add the garlic, chile, zest, juice and oil, and mix by hand with a fork or a tablespoon.

Smash the chickpeas with the flat side of a chef’s knife, to break the skin. Sprinkle the curry and black pepper on the garbanzos, add to the bowl, mix again, and top with herb garnish if desired.

Serve with corn tortillas or toasted chips, sliced jicama triangles and sliced cucumber circles. Enjoy!

Nutritional Data Per Serving (3 servings):193 calories, 17 g carbs, 14 g fat, 3 g protein, 125 mg sodium, 7 gram fiber.

Adapted from La Puma J. “ChefMD’s Big Book of Culinary Medicine”, Crown, 2008.

(c) John La Puma, MD, Santa Barbara, CA, 10.2013

*See John’s TEDMED bio page for references and resources that support these claims.

Why be normal? Q&A with Rosie King

Rosie King diagnosed herself with a high functioning form of autism (Asperger’s Syndrome) at age nine and has become a spokesperson for autism in the United Kingdom, including hosting an Emmy award winning BBC documentary on the subject. Shortly after her 16th birthday, she spoke on the TEDMED 2014 stage about her journey.

We asked Rosie a few questions to learn more about her remarkable story.

Why does this talk matter now?

I think the ideas I share in my talk have always mattered.  Society is at a stage where it is beginning to understand equality– I want this to move on from addressing racism and sexism, to addressing discrimination in all areas.  This is the only way to have a civilized society.

Gratefully not normal: "I wouldn't trade in my autism and my imagination for the world." Rosie King, TEDMED 2014.

“I wouldn’t trade in my autism and my imagination for the world.” Rosie King, TEDMED 2014. Photo, Sandy Huffaker for TEDMED.

What legacy would you like to leave?

I want everyone in the world to know that it is important to be themselves.  I come from a family where everyone is different.  We could be a sad family but we have always been encouraged to be proud of ourselves and celebrate our talents.  If the whole world was like my family then it would be a joyful world.  I want to take a little bit of my family’s attitude out there.  It could be like flicking a switch, and I hope that my talk will be that switch.  To ask someone to be anything other than who they really are is cruel, like killing their real self.  Also, that genuine self that could bring so much color to the world!

What did you learn at TEDMED?

Denise [TEDMED speaker coach] taught me about body language and how to speak to a big audience–  that was useful.  I also listened to a very interesting talk [Rebecca Adamson] about how Native American people were treated.  This made me very upset but also glad that it was being brought to light.

For all inquiries regarding speaking engagements or to learn more about her current work, please contact Joanna Jones.

Keep up with Rosie and her family on their blog, My Perfectly Imperfect Family, and check out the books Rosie has illustrated authored by her mother, Sharon.