The Stories We Tell Ourselves

This guest blog post was written by TEDMED 2015 speaker, critically acclaimed author, and sexuality investigator, Daniel Bergner.

The subjects I’ve chosen as a nonfiction writer may seem pretty scattered. My first nonfiction book, God of the Rodeo, was about a group of convicts in Louisiana’s Angola Prison, where almost all the inmates are serving life without the slightest chance of parole. My fourth book, What Do Women Want?, was the topic of this TEDMED talk – female desire. But things aren’t as scattered as they seem. In fact, I’m fairly obsessive. Over and over, throughout my writings, I’ve dealt with two subjects, race and eros. And as I’ve focused on these subjects, the common thread is how we perceive and understand ourselves.

Daniel Bergner's new book, Sing for your Life.

Daniel Bergner’s new book, Sing For Your Life.

That’s what my TEDMED talk is about—the stories we, as a culture, tell ourselves about female sexuality and the way these stories permeate our expectations about men and women. Shortly after I gave my TEDMED talk, I overheard someone remark that she couldn’t stand it when men speak about female sexuality. While I didn’t discuss it with her, I do think that her preconceptions might have prevented her from really hearing my talk, which was based largely on the work of female scientists, like Meredith Chivers. The goal of my talk was, at the very least, to call into question some of our conventional ways of seeing the world we live in, and the assumptions that tend to serve men awfully well.

This is again a theme in my new book, Sing For Your Life. It’s about the personal and artistic journey of an extremely unlikely opera singer, Ryan Speedo Green, a young African-American man who grew up in rural Virginia in a bullet-riddled shack across the street from a drug dealer’s den, who was locked up as a kid in Virginia’s juvenile facility of last resort, and who is starring at the Metropolitan Opera this fall in La Boheme. It’s a story about all that we, too often, fail to see in each other, and all that we can easily fail to see in ourselves.

Sing For Your Life is about blindness, and about seeing, as I think all my books are. Which is maybe true about all the books on our shelves, the ones we care about. They’re about the unexpected, the unlikely, the things that go unnoticed, coming into view.

Critically acclaimed author and sexuality investigator Daniel Bergner shakes the foundations of society’s core beliefs about female desire and the science of promiscuity.

The revealing power of creative disguise

This guest blog post is by TEDMED 2015 speaker Melissa Walker, a Creative Arts Therapist at the National Intrepid Center of Excellence.

This past month, I returned from a work excursion to Washington State and Alaska full of excitement and hope. My personal travels have never taken me to the Pacific Northwest or the Last Frontier, so the incredibly beautiful backdrop of cities such as Seattle and Tacoma, WA, and Anchorage and Seward, AK, was the cherry on top of our goal to spread the treatment we are most passionate about across the nation.

Melissa Walker, photographed at the National Intrepid Center of Excellence with masks that are part of her art therapy program with the military. melissa.s.walker12.civ@mail.mil PR Contact: Mary El Pearce Public Affairs Liaison, National Intrepid Center of Excellence (NICoE) Associate, Booz Allen Hamilton NICoE Public Affairs Line: 301-319-3619 Booz Allen Office: 202-354-9412 Mobile: 404-285-5005 pearce_maryel@bah.com

Melissa Walker, photographed at the National Intrepid Center of Excellence with masks that are part of her art therapy program with the military. Photo credit: Rebecca Hale, National Geographic

Our team, composed of Department of Defense (DoD) and National Endowment for the Arts (NEA) staff, visited military traumatic brain injury (TBI) outpatient clinics to discuss the integration of the creative arts therapies into their treatment models. We also met with state and local arts agencies, community arts organizations, and local artists to encourage arts involvement of active duty military service members and veterans outside of, and alongside, the clinical setting.

Prior to these visits, the team also traveled to TBI clinics on military bases in North Carolina and California with the mission to expand, replicate, and support access to creative arts therapies treatment within the DoD. All were met with enthusiasm and a desire to offer treatments such as art therapy, music therapy, dance therapy, and drama therapy to our recovering military service members.

Though creative art therapists have been employed by the DoD and the US Department of Veterans Affairs (VA) for many years, it wasn’t until very recently, after two Federal Agencies–the NEA and the DoD–united in what should be considered a role model Partnership, that the creative arts therapies were elevated to a nationally accepted level as a core integrative treatment for military service members diagnosed with the signature, invisible wounds of our most recent wars, TBI and underlying psychological health concerns to include post-traumatic stress (PTS).

This all began in 2011 when the NEA partnered with the National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center, Bethesda, MD, to adapt their Operation Homecoming creative writing initiative to the military healthcare setting.   The NEA offered to integrate creative and therapeutic writing into the existing Healing Arts Program, which was then composed solely of art therapy.  The integration of creative and therapeutic writing into the Healing Arts Program at the NICoE was a success.  Patient response to the writing, as well as a two-year survey ranking art therapy in the top five treatments of over forty that the service members found to be beneficial to their recovery, prompted the Partnership to begin exploring ways to expand creative arts therapies offerings.  A music therapy program began at NICoE in 2013 and shortly after, an art therapist was embedded at the NICoE Intrepid Spirit in Ft. Belvoir, Virginia – one of nine planned NICoE satellite centers.

There, positive patient and staff feedback led to the transition of that art therapist from contractor to a permanent DoD civilian and then the position was back-filled with a music therapist. The majority of service members treated at NICoE are stationed in Virginia Beach, so shortly after an art therapist was hired via the Partnership and embedded in the community there. It was crucial that service members responding to art therapy at the NICoE have follow-on care back at their home base. And at NICoE, creative arts therapies offerings continued to expand when the NICoE hired a Wellness Coordinator who is also a dance/movement therapist, and the NEA brought in an additional art therapist so that I could dedicate more of my time to outreach and research efforts.


A mask created by an active duty member as part of Melissa’s Healing Arts Program.

Fortunately, Capitol Hill has responded very positively to the Partnership’s impact, and this year an increase of 1.9 million dollars in NEA funding was implemented for the replication and expansion of the NEA Military Healing Arts Network within not only key active duty military treatment facilities across the nation such as the ones I mentioned earlier, but also within the VA and community settings. As service members transition from active duty to becoming veterans and members of society, it is important that we ensure access to the arts so that they can serve as a therapeutic outlet across the continuum.  We would also like to bridge the divide between clinical and community arts settings, ensuring warm hand-offs as service members transition from active duty to retirement.

The goal of nine additional, for a total of twelve, clinical settings to the Partnership within the DoD and VA has been set for integration this year alone. Each of these settings will be connected to promising community arts programs. This means access to the arts as a form of healing and resilience for over 10,000 service members and veterans within our healthcare system and community, per year.

I, for one, cannot wait to see the amazing outcomes I have witnessed within the Healing Arts Program at the NICoE spill out and touch every service member and veteran possible over the next five, ten, twenty years… across ALL states. In the words of a former NICoE Director who has chosen to work for the Partnership post-retirement: “The creative arts therapies are no longer a nice to have, they are a NEED to have.” And this expansion is making that possible.

Portrait_MElissaWalkerCreative arts therapist Melissa Walker describes how she creates a haven where military service members recovering from traumatic brain injury and mental illness can safely unmask their invisible wounds.

How to Solve the World’s Sanitation Problem: Let the Problem Get Bigger

This guest blog post is by TEDMED 2015 speaker Peter Janicki, a founding member of Janicki Industries.

I have been working on large mechanical engineering projects since I got out of college 25 years ago, but the last 3-4 years have been by far the most exciting and rewarding. When you travel through the streets of India or Africa you see some of the most industrious, talented and hardworking people ever, but many of them are just struggling to survive and the sanitation conditions are awful. Making money using fecal sludge, garbage and other waste as the feed stock to radically transform these conditions is my dream.

OP S100 (4) Dakar

Peter Janicki’s Omni Processor in Dakar, Senegal.

With this dream, I designed a machined we call the Omni Processor, which evaporates the water out of sewage, uses the dried solids as fuel to power a boiler, makes high pressure steam, and drives a steam engine to produce electricity. The great news is that my first such machine has been operating in Dakar, Senegal for over a year now, and has passed many milestones. Last month, the water we are making from raw sewage was tested and passed every possible test with flying colors. The steam engine in our Dakar unit is now powering the Omni Processor itself, the control offices and air conditioners, as well as large customer electrical loads.

Making affordable electric power and clean drinking water from sewage is a tremendous achievement, and we recognize that. When you walk through our engineering offices, you can feel the excitement and optimism for the future. Nothing is perfect and we are continuing to improve the power output and overall mechanical system, but we will get there. It is inevitable that, with continued focus and perseverance, the equipment will work as dreamed.

When I reflect upon the journey so far, it is clear that I woefully underestimated the engineering effort to design, build and deploy this machine. But, in some ways, this is my life story. I am overly optimistic and this is part of the magic to being successful. I look at what appears to be an impossible problem and say, “Ok, we can do this, let’s go for it.” And, in the end, this optimism, coupled with tremendous perseverance, wins. While there will always be opportunity to improve the technology, the next real challenge is successfully integrating this machine into the social and political landscape of these cultures. I recognize that this is, by and large, not an engineering problem; rather, it is a matter of understanding human nature and culture outside of my area of experience. We can and will learn from others as we install equipment in these communities.

Like so many other problems I have faced, I am probably underestimating how hard it is going to be to get this perfect, but I will remain optimistic. In the end, with perseverance, focus and hard work, I am confident we will win on this front, as well. We will figure this out. We will not stop until we do. My team and I work 24/7, day after day, year after year, and never give up. I talk to my team on Saturday night, or late in the evenings, or at 5 o’clock in the morning—whenever inspiration arrives. We win, because we focus on winning. Ideas come to you when you are dreaming, going for a walk, taking a shower–not just from 8-5 in an office. Seize the moment when it comes. Do not let the opportunity of inspiration pass.

Janicki_crop_portraitEngineer Peter Janicki describes his unique methods for setting industry standards across sectors, from airplanes and boats to his current fascination–basic sanitation in low-income countries.

The hidden ingenuity of nurses: Q&A with Anna Young

In her TEDMED 2015 talk, MakerHealth CEO and Co-Founder Anna Young describes how she is bringing rapid prototyping tools into hospital to enhance the natural, do-it-yourself problem solving abilities of MakerNurses, frontline clinicians, and patients who innovate to improve health care. Using a maker mindset of hands-on problem solving and experimentation, nurses, respiratory therapists, medical residents and patients in the MakerHealth network are reinventing medical technology. We caught up with Anna to learn more about her work, and what’s on the horizon for MakerNurse and MakerHealth. 

Q: Are there any recent MakerNurse innovations that you are especially excited about?

A: The most impressive projects we hear are the ones that launch from idea to prototype in less than a week! When we launched MakerNurse, nurses reached out sharing their ideas. Now, nurses are calling us to share their prototypes! Some of the recent nurse-made projects we’ve guided include: home care devices for improved patient hygiene, a custom patient support pillow, and a toy bear modified to support a PICU patient’s ventilator tubing.


Driscoll Children’s Hospital, Corpus Christi, TX

Earlier this summer, Driscoll Children’s Hospital in Corpus Christi, TX, one of the MakerNurse Expedition Sites, performed an incredible operation to separate two conjoined twins. From surgical planning to the patients’ rehabilitation, the process was full of health making that made us so proud to be working with Driscoll. The surgeons modified two toy dolls to match the anatomy of the twins and 3D printed a model of their organs from a DICOM file to help with surgical preparation. The nurses created custom, color-coded surgical caps to identify the clinicians for each of the twins: one team wearing purple and the other team yellow. During the rehabilitation, the Occupational Therapists and Child Life Specialists built an interactive mobile from PVC tubing, custom dimensioned around the bandage constraints of the twins.

For this care team, a maker mindset and access to prototyping tools helped them care for delicate, high-risk, N=1 patients. The innovations at Driscoll – the surgical models, custom caps and PVC rehab mobiles will never be commercialized because the market is too small. If you think about it though, the patient doesn’t care. So with a MakerHealth toolset and mindset, this team in Corpus Christi is reinventing care.

Q: You started your journey with nurses. How did MakerNurse grow to reach other health care professions and patients through MakerHealth?

A: Our academic roots at the Little Devices Lab at MIT had been looking at the science of medical making for a long time in hospitals in Nicaragua, Nigeria and Ethiopia. We got a huge shot in the arm when the Robert Wood Johnson Foundation supported the translation of our research framework for international health making into a framework for finding frontline MakerNurses across the American health care system. In the US, nurses are natural hands-on problem solvers and leaders in making, but they don’t operate alone in their tinkering. As we roll out the MakerHealth Program in hospitals, we are working with doctors making surgical tools, OTs and PTs creating adaptive devices and even police teams joining the community by 3D printing lock jigs. We’ve created on-ramps and just-in-time learning blocks to help all staff inside of the hospital learn the skills needed to prototype.

This same model of medical prototyping and sharing grew beyond the hospital walls. We saw with a parent in Ohio, who refused to wait for Medicaid to kick in to reimburse a walker for his daughter who has an endocrine disorder. Instead, he rolled up his sleeves, went into his garage and transformed his grandmother’s adult walker into a child-size one for his daughter. Bonus, he spray painted it purple. Her favorite color. This is the heart of health making, people who are driven to create solutions for the patients closest to them.

Q: What are today’s grand visionary plans of MakerHealth?

A: Health making is revolutionizing the way care is delivered in hospitals, clinics, and home care divisions across the globe. Patient-made machines are changing the provider-patient dynamic. The solutions by frontline staff are making care better and more affordable. Everyone is working to get rid of the black box of medicine: hidden engineering, hostage data and runaway prices. When the status-quo medical device becomes too cost-prohibitive, we see emergency response teams in Seattle respond by rolling out their own DIY kits. We are driven to show health systems how to move these health prototypes into clinical care. Right now, medicine is a temple of evidence raised practice. We’re bringing back an experimental mindset where everyone gets to ask the questions-and everyone gets to build the answers. You need tools: so we are going to continue to grow our hospital makerspaces, we’re writing new types of medical and nursing school curriculum, and folks can now order prototyping kits shipped to their home. We are reinventing health care one maker at a time.

annayoung_blogcaption MakerNurse co-founder Anna Young describes how she is bringing rapid prototyping tools into hospital units to enhance the natural, do-it-yourself problem solving abilities of nurses who innovate to improve patient care on a daily basis.

A Beginner’s Guide to Insect Farming

This guest blog post is by TEDMED 2015 speaker Shobhita Soor, a founding member of the Aspire Food Group.

At Aspire, we often get inquiries about how to start and scale up insect farms. The truth is, starting up a never-been-created-before edible insect farm is an exciting but challenging task. There is so much research to do, and so many unknowns around scaling up farming of the insects, the market’s response to your product and price point, and packaging possibilities. At Aspire, we faced these hurdles as well as the adjustments to living in a new country!


Edible insects can compliment delicious dishes or can simply be eaten on their own as snacks.

The crucial first step is to have an insect to market match. When choosing which insect to farm, our most basic question is: “Do people eat this already?” or “Will people even considering eating this?”. In Central and Southern Ghana, for example, the palm weevil larva is already consumed in a harvested form. Since the farmed version is almost identical but safer, we were sure it would be acceptable to consumers. In that case, an interesting nuance that we had to pull apart was whether buyers would be willing to pay for an otherwise harvested (and free!) product. We found that, since the supply in the wild had decreased due to increased use of pesticide in palm plantations, there was a strong desire for a steady supply of palm weevil larva. In the United States, however, it was a bit trickier. We had to look at analogous products and do some market testing to know whether segments in the American food market were ready for cricket powder and roasted crickets.

Once we have an insect that people are actually excited to eat (and willing to pay for!), we want to make sure that the insect species is amenable to large-scale farming in a cost-efficient manner. This can be a long process–we look at other existing edible insect farms, traditional livestock rearing, and methods with which to make this more efficient by collecting a lot of data on our farms. Early on, we also consider how to process and package insects. Since edible insects have often been harvested and eaten shortly thereafter, we find innovative ways of processing and packaging insects, so that they are not only attractive to the consumer but also safe for consumption.

The nutritional profile of the insect in question is also tantamount to our choice of insect – our goal is to choose an insect that matches the nutrition needs of the market. Take palm weevil larva, for instance – it’s rich in essential fatty acid and protein making. That means it’s well-positioned to address the problems of child stunting; it’s also high in zinc, which aids in preventing diarrhea. In the United States, we aim to farm crickets as a lean source of protein that is also resource-efficient. Our goal is to displace traditional sources of protein (that can wreak havoc on the environment) with alternatives that are healthy for our planet. Currently, there is little data on the resource consumption of edible insect production, and this is something that we try to consistently measure.

These are just a few of the considerations we take into account when starting up an insect farm ¬– yet another important factor is the political and economic climate of the country in question. Changing food culture is complex, as people’s food traditions tend to be strong traditions. That said, in the Western world, we’ve begun to see culture shift where insect consumption is becoming more popular. From cricket flour in consumer packaged goods to whole insects showing up on restaurant menus, people are beginning to embrace insects as a part of their normal diet. We’re so excited to see how these nutritious and sustainable sources of protein will improve our health, and the health of our planet. This is just the beginning!

Balancing Medical & Musical Worlds: Q&A with Suzie Brown

In her TEDMED 2015 performance, cardiologist and singer-songwriter Suzie Brown and her husband, Scot Sax, give a vulnerable, evocative performance that tugs at our heartstrings. We caught up with Suzie to learn more about the delicate balance between pursuing her musical passions and practicing cardiology.

Credit: Zoey Sless Kitain

Credit: Zoey Sless Kitain

TEDMED: Can you tell us more about the fine line between exposing your outside life to your patients, being vulnerable with them, and maintaining the level of expertise, stoicism, competence, and objectivity that is expected when playing the role of a doctor?

SUZIE: It IS a fine line. When I am at the hospital, I am 100% dedicated to my patients and I would never want there to be any question about that. For that reason, I generally do not volunteer that I’m a musician, or even that I work part time. Once I have established a more long term relationship, and my commitment to them and competence as their physician has come across, I find it easier to talk about (but I still don’t bring it up). I hope that they feel it on some level though, in that I am more vulnerable and empathetic than I would be otherwise.

TEDMED: How do you balance the medical professional side and musical sides of your life?

SUZIE: It’s not easy. And it’s become even more complicated now that I have kids. My schedule currently alternates between 2 weeks working as a doctor and two weeks “off” from medicine, which is my time for music. After my two doctor weeks, I’m usually exhausted, and I’m always missing my family like crazy. I need to physically and mentally recharge before I’m able to be creative, which takes time. I can’t wait to spend time with my husband and daughters after being away so much at work. In between family and recharging time, I squeeze in my creative time. These days that mostly consists of songwriting with other artists in Nashville, though I still play shows and make albums. Inevitably, the two weeks “off” goes by in a flash. I often wish I had more music time, though I’m SO grateful for the time that I do have.

TEDMED: Do you think the fact that you’re a musician makes you a better doctor?

SUZIE: Definitely. Having time for music allows me to recharge, to replete my emotional reserve, so I have more to give to my patients. It also allows me to access my feelings and maintain a healthy amount of vulnerability – without time away, it’s easy to shut down emotionally, just to get by.

Download the song from Suzie’s TEDMED 2015 performance, “Sometimes Your Dreams Find You,” for free here!

Found in Translation – Kyoto style

By guest contributor and TEDMED 2015 Speaker Daria Mochly-Rosen, PhD and Rosanne Spector

This week I’m visiting Kyoto University to spark something similar to SPARK, the program at Stanford University that translates fundamental academic research into drugs and treatments to benefit patients.

I founded SPARK 10 years ago when I realized how hard it was for me, a professor at Stanford’s medical school, to get the world of drug developers interested in a discovery from my lab that I felt sure could improve patients’ lives. In my TEDMED talk last year, I talked about SPARK’s successes at promoting translational research. Among them: More than two dozen of the Stanford projects have launched start-ups or been licensed to existing companies. Meanwhile, other institutions inside and outside the United States are using SPARK as a template for programs of their own — which brings me to this week in Japan.


Photo courtesy of http://kodo-kan.com/

After a very productive day with several professors at Kyoto University, my host, associate professor Tomoyoshi Koyanagi, PhD, took me to a very old tea house for a tea ceremony, hosted by Makoto Sarata. Sarata-san is an assistant manager in the Entrepreneur Nurturing Support Department of the Advanced Science and Technology Management Research Institute of Kyoto (a mouthful and yet incomplete title).

As I entered the beautiful tea house, surrounded by a manicured moss garden, I met Sarata-san, a strongly built man who had a huge smile and boundless energy. We sat on the tatami floor mat, drank the green foamy tea in large ceramic bowls, and talked. As you’ll see, the tea house turned out to be the perfect place to talk about translational research.

Sarata-san talked about design thinking and “smile value,” which are his tools to encourage entrepreneurship. Using these tools, he triggers participants to think creatively and positively by first identifying and choosing a problem and only then working on solutions and sorting through many of them to find the one to focus on. I contrasted these tools with our approach in SPARK, which has to include building on years of research that identified a lead (a beginning) for a solution. We talked about SPARK’s challenge, as the process depends on so many diverse types of expertise (medicine, chemistry, material science, pharmacology, etc) and how that generates language barriers.

As we continued, I also heard more about the ancient and beautiful tea tradition. Sarata-san told us that after finishing the tea, it’s the custom for guests to carefully inspect the bowl and admire it from all sides, as each bowl is unique. I immediately picked up my empty bowl from the tatami and held it high to show my appreciation. What a cultural faux pas! After a belly laugh, Sarata-san explained the mistake: The bowl was over 200 years old and I showed disrespect. The proper way is to bend down close to the tatami and elevate the bowl only slightly, so not to risk breaking it. Lost in translation?

As we were putting on our shoes, preparing to leave this ancient tea house, Sarata-sun, called out the tea house chairperson, Dr. Kanako Hamasaki. Hamasaki-san, a beautiful young woman, has a PhD in Kodo, the “way of fragrance.” I am not sure if I understood her explanation of her expertise on the effect of incense on the body. But the discussion was cut short when she exclaimed: “I have the same boots as yours!” We were just two women, sharing the same language – women’s love for shoes.


Dr. Daria Mochly-Rosen is a professor of Chemical and Systems Biology at Stanford University and is the founder and director of Stanford’s SPARK program. In her TEDMED talk, Daria highlights the value of connecting academia and industry to enhance translational research. 

How Should We Train Medical Students for a Digital Future?

By guest contributor and TEDMED 2015 speaker Robert M. Wachter, MD

When I was a medical student about 30 years ago, I knew what a computer was, but the machines didn’t have any relevance to my professional life. When I started on the wards, all of my clinical notes were handwritten on pieces of paper stored in three-ring binders. We read paper journals, photocopied and handed out articles to our colleagues, and clipped out summaries of “keepers,” filing them in little recipe boxes for later review. To look at our x-rays, we trekked to the radiology department, since that was where the only copy of the film was stored. All of our laboratory results came back on flimsy carbon copy sheets of paper that were filed, in rough alphabetical order, on a rickety poker table outside the clinical laboratory.

In retrospect, it’s amazing that we didn’t kill more of our patients.

In the past five years, fueled by about $30 billion in federal incentive payments, medicine has finally become a digital industry. More than 90% of American hospitals now have electronic health records, as do the vast majority of physician offices. Decades after most other information-intensive industries switched from paper to silicon, in medicine, the x-rays, the three-ring binders, and the card tables have finally left the building.

Clearly, the world of today’s physicians will be vastly different from the world I entered in the early 1980s. Just as clearly, the training of future physicians must evolve for their work in a digital healthcare system. But how should it change?

Digital MedicineIn order to understand this, it’s important to make clear how digitization changes the nature of medical practice. The first issue is how one accesses medical knowledge. Online resources are now a click away, and more sophisticated electronic health records build in decision-support, which can do everything from reminding you that a patient is allergic to a certain antibiotic to guiding you to a well-vetted, evidence-based protocol for the management of a patient with a stroke.

On top of that, there’s the exploding field of analytics. The same technology that allows Amazon and Netflix to say, “Customers like you also liked…” will soon be applied to medical knowledge. Although your average physician won’t be performing big data analytics in the course of her workday, she will need to understand the results of such analytics, and be skilled at asking the big data experts (or the computers themselves, as the tools become more user-friendly) questions that can be answered effectively by existing data.

The role of patients will be transformed. As we’ve seen in other industries, computerization is The Great Democratizer. Patients will be far better informed through online resources, and will no longer be entirely dependent on the physician for expert knowledge. In certain cases, patients will also have access to apps and other tools that allow them to self-manage problems that used to require a physician visit. When they do need to see the doctor, many, perhaps most, of their visits will occur through telemedicine.

What does this mean for the training of future doctors? First, not all physicians will need to be experts in HTML. Clearly, some clinicians will want careers that blend informatics and medicine, and they should be encouraged to pursue this important work. And all students will need to understand the basics of how computers work in a medical context, but that is not the core issue.

Rather, the key change is that students will need to be trained to be leaders in improving systems of care, in working effectively in teams, in partnering with patients in new ways, and in using digital capabilities to enhance all of this work. While they will have less need than in the past to memorize everything in the textbook, it will be a mistake to say that they don’t really need to know very much since all the answers are a web search away. In many cases, it is the deep foundational knowledge that allows you to know when you need to learn more, or when the computer is giving you an answer that is inappropriate for a given patient’s situation. The physician of the future will still need to know quite a lot.

Probably the most important challenge will be one that gets even harder as the information technology gets better: balancing the technology with the humanity of medicine. We must train our future doctors – who will not know anything other than a digital environment – to concentrate on the real patient, not the digital incarnation of the patient, which Abraham Verghese calls the “iPatient”. With all of the data in the computer, this is easy to forget. But, as I wrote in The Digital Doctor, even when that wonderful day arrives when we have finally coaxed the machines into doing all the things we want them to do and none of the things we don’t, we will still be left with one human being seeking help at a time of great need and overwhelming anxiety. The relationship between a doctor and a patient does not feel transactional now, and I don’t think it will then. Rather, it will remain vital, scary, ethically charged, and deeply human.

It will take great discipline and all the professionalism we can muster to remember, in a healthcare world now bathed in digital data, that we are taking care of human beings. The iPatient can be useful as a way of representing a set of facts and problems, and big data can help us analyze them and better appreciate our choices. But ultimately, only the real patient counts, and only the real patient is worthy of our full attention.


Bob Wachter, digital medicine expertIn his TEDMED 2015 talk, renowned UCSF internist, author and patient advocate Robert M. Wachter shares his struggle to balance patient empowerment with patient safety in our digital age.

The Importance of Replication Studies


By guest contributor and TEDMED 2015 Speaker Elizabeth Iorns, PhD

Every year, billions of dollars are spent funding biomedical research, resulting in more than one million new publications presenting promising new results. This research is the foundation upon which new therapies will be developed to enhance health, lengthen life, and reduce the burdens of illness and disability.

In order to build upon this foundational research, these results must be reproducible. Simply put, this means that when an experiment is repeated, similar results are observed. Over the last five years, multiple groups have raised concerns over the reproducibility of biomedical studies, with some estimates indicating only ~20% of published results may be reproducible (Scott et al. 2008, Gordon et al. 2007, Prinz et al. 2011, Steward et al. 2012, Begley and Ellis 2012). The National Institutes of Health (NIH), the largest public funder of biomedical research, has stated, “There remains a troubling frequency of published reports that claim a significant result, but fail to be reproducible. As a funding agency, the NIH is deeply concerned about this problem”.

shutterstock_261331172Despite the growing concern over lack of reproducibility, funding for replication studies, the only way to determine reproducibility, is still absent. With no funding systematically allocated to such studies, scientists almost never conduct replication studies. It would be interesting to obtain the exact numbers, but it appears that last year the NIH allocated $0 to funding replication studies, out of a $30B+ budget. In the absence of replication studies, scientists end up wasting precious time and resources trying to build on a vast, unreliable body of knowledge.

It is easy to see why funders might shy away from funding replication studies. Funders want to demonstrate their “impact,” and it is tempting for them to solely focus on funding novel exploratory findings that can more easily be published in high profile journals. This is a mistake. Funders should instead focus on how to truly achieve their stated goals of enhancing health, lengthening life, and reducing the burdens of illness and disability. Although allocating a portion of funding towards replication studies would divert funds from new discoveries, it would enable scientists to efficiently determine which discoveries were robust and reproducible and which were not. This would allow more rapid advancements by allowing scientists to build upon the most promising findings and avoid wasting their time and funding pursuing non-robust results.

Some researchers find the idea of replicating previous studies unnecessary or even offensive. However, it is the responsibility of the scientific community, including funders, to work as quickly and cost effectively as possible to make progress. Introducing replication studies as part of the process provides an effective way to enable this.

If you would like to see funding specifically allocated for replication studies, please register your support here. We will share this information with funders in the hope that it will encourage them to establish funding programs specifically for replication studies to improve the speed and efficiency of progress in biomedical research.


In her TEDMED talk, cancer biology scholar and CEO of Science Exchange highlights the importance of funding reproducibility studies to advance scientific progress while maintaining its integrity.

The art of healing across cultures: Q&A with Laurie Rubin

Laurie Rubin works to promote healing across cultures.

Laurie Rubin

Performance artist and TEDMED 2015 speaker Laurie Rubin and her wife Jenny Taira founded Ohana Arts in 2014, a non-profit whose mission is to promote peace and world friendship through the universal language of the arts. They recently performed at a special ceremony in Hawai’i in memory of the recent 70th anniversary of the tragic Hiroshima nuclear bomb calamity. We caught up with Laurie to learn more about her and Jenny’s work to promote cross-cultural understanding and healing.

TEDMED: How did you first become interested in focusing on cross-cultural healing in your work?

LAURIE: From the time I was seven years old, I was in Hebrew School learning about the Holocaust, and the devastating loss of six million Jewish people that happened less than half a century before I sat in the classroom. The Holocaust made several appearances in my history classes throughout my elementary, middle, and high school education. I learned then what war and hate could do to human beings, and how mutual understanding and the necessity to heal was part of the universal human experience. Therefore when my wife Jenny, who is Japanese American, told me the effect the Hiroshima Peace Memorial Museum had on her, as well as Sadako Sasaki’s story, I had many mixed emotions. I first thought, “Why have I never heard about Sadako and her international peace movement?” My second thought was about the message that was consistent throughout my Hebrew School education, “Never again!” It was of the utmost importance to hear from Holocaust survivors about the kinds of things human beings are capable of doing to other human beings so that future generations don’t repeat the same behaviors and make the same grave mistakes. Yet, the only unit I remember doing on Hiroshima was in the 8th grade, and it was just luck that I had that particular teacher put John Hersey’s book, “Hiroshima” in his syllabus at our progressive school where teachers had leeway to create their own curricula. I realized that as a Jewish artist, it is my responsibility to keep enforcing the message of “Never again” by telling more stories beyond those of my people. “Peace On Your Wings,” is a musical Jenny and I wrote about Sadako Sasaki, a 12 year old girl who died of Leukemia resulting from radiation caused by the atomic bomb dropped on Hiroshima, and who became famous for starting an international peace movement through her thousand origami cranes. It is an example of how one’s universal story can help to heal others who suffer from the atrocities caused by war, and an educational step toward preventing history from repeating itself. I realized that if you educate the world about one piece of history, it would simply get placed into a box that people would take less and less seriously over the decades. However, if you make people realize that human cruelty has happened to many people and nations, it drives the point home that it could happen again, and to us. Jenny and I have been trained as classical musicians, and have realized over time that we could use art, music, and theater to make a difference. It is our life’s work and mission to make sure we accomplish this in our unique way by telling as many poignant stories as possible and providing a sounding board for underrepresented voices.

TEDMED: Could you share any experiences you’ve had that have shaped your drive to play an active role in cross-cultural healing?

LAURIE: As a blind student mainstreamed in regular schools, I received a great education, but often felt isolated, and at times bullied. My braille books and adaptive equipment often made me feel like the alien that had unceremoniously waltzed into the lives of sighted children, disrupting their sense of normalcy. It wasn’t until high school when I joined summer programs for advanced musical study that I started making the kinds of friendships I felt deprived of in my school setting. Music was the level playing field for all of us in spite of our differences. Jenny had also gone to similar summer programs. Music brought us closer to youth from other countries, economic, and ethnic backgrounds. When we moved to Hawaii, where Jenny was born and raised, we decided to start Ohana Arts to provide a similar kind of formative experience for the youth here, and the rewards we see are so incredible. We see ourselves through the eyes of the students we work with. We see how the performing arts fosters acceptance, self expression, and a safe haven for those who have felt “different.”