Healthy risk-taking for “at-risk” individuals

By Kayt Sukel, science journalist, TEDMED 2014 speaker and guest blog contributor

How can we encourage individuals from “at-risk” populations to take healthy  risks, when we can’t even agree on what risk actually is?

To start, I think we need to make sure that individuals, public health systems, and educational systems are using the same vocabulary when they discuss these kinds of issues. The word “risk” is used in so many different ways—and we tend to talk about it in rather contradictory extremes. “Risk is bad. It will lead to poverty, danger, and death.” Or, “Risk is good. It’s the key ingredient for happiness and success.” The truth, as is often the case, resides somewhere in the middle. As I learned while researching The Art of Risk: The New Science of Courage, Caution & Chance, work in neuroscience shows, more and more, that risk is a key component to learning and skill building. Yet, people still tend to talk around risk. There has recently been a more conscious effort, in the psychological and epidemiological communities, to try to use the term “risk” less—especially when the parties mean “impulsivity,” “sensation seeking,” or some other manner of negative behavior.

We also need to acknowledge that there is risk in every decision one makes, every single day. While the science shows that risk is necessary for learning and growth, that doesn’t mean it’s comfortable or easy. Saying yes to everything is exhausting. Being judged for the risks you take, especially when it somehow gets linked back to the color of your skin, your socioeconomic background, or your gender, is infuriating. Educators and other stakeholders need to understand that, for at-risk populations, putting yourself out there can come at a significant cost. Sure, in the long term, it may not be as great a cost as not pursuing an important professional or personal goal. But we should acknowledge that risk, especially one that makes you vulnerable to criticism and ridicule, is a scary proposition. And, if there isn’t some sort of scaffolding there (in the form of good mentorship, for example) it can be hard for at-risk individuals to see what the long term benefit of risk-taking could be. It’s important that we collaborate, as a community, to make sure that scaffolding is there–for everyone–so we do have room to encourage healthy risks.

The good news is that already have the tools in our arsenal to encourage healthy risk-taking in all populations. We’ve had them for a long time. It’s as simple as providing safe arenas in the arts, sports, and sciences where students even as young as elementary age can learn how to question, to innovate, to fail, to engage, and to move forward.

I know, it may seem like I’m contradicting myself. Risky behavior in safe arenas? What does that even mean? To me, it’s a matter of giving individuals, all individuals, opportunities to test themselves in new ways. Giving them places to do it where the cost of failure is not too great to bear. Time and time again, we’ve seen that music, art, theatre, science clubs, sports, and other extracurricular activities all provide opportunities for individuals to try new things and really work at the edge of their performance ability. This teaches those students key lessons in emotional regulation, problem solving, teamwork, personal responsibility, and perseverance. If we can make these arenas more inclusive, it’s there that we can empower females (both cis and trans) and LGBTQ populations—as well as other at-risk populations—to better understand their own strengths and weaknesses and, ultimately, develop really healthy risk-taking skills. The kind of skills that transcend the school and playground—and help them become more successful in everyday life, no matter what kind of goals they decide to pursue.

Unfortunately, these are exactly the kinds of programs that we keep cutting, both inside and outside schools. If we continue along that vein, it will not only be to the detriment to at-risk populations, but to society as a whole.

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kaytJournalist and science writer Kayt Sukel shared insights into the neuroscience of risk-taking and how play during childhood and adulthood impacts the way we make decisions as adults in her 2014 TEDMED talk, Eliminating Penalties for Playing Out of Bounds. Check out her new book, The Art of Risk: The New Science of Courage, Caution and Chance.

Guiding Evidence for Gun Violence Prevention: Q&A with Daniel Webster

In his 2014 TEDMED talk, Daniel Webster, Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and Director of the Johns Hopkins Center for Gun Policy and Research, examines some surprisingly hopeful possibilities that exist for a controversial public policy conundrum that seems to have no universally acceptable answer. We asked Daniel a few questions to learn more.

I don’t think that the level of gun violence we experience now is here to stay. Nor is it built into American culture or American law.  I believe that within 20 years, the United States can reduce our murder rates by 30% to 50%.

“I don’t think that the level of gun violence we experience now is here to stay. Nor is it built into American culture or American law. I believe that within 20 years, the United States can reduce our murder rates by 30% to 50%.” Daniel Webster, TEDMED 2014

What motivated you to speak at TEDMED?

I felt that I had important perspectives and research to help America address one of its most important and vexing public health problems.  Unless you know the data and have a long-term perspective, it is easy for those who desperately want to see change to think reducing gun violence in America is hopeless.

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

Recent political gridlock in Washington, DC on almost all issues, including guns, can prevent the vast majority who support stronger laws to keep guns from dangerous people from engaging on the issue, surrendering important policy decisions to people with the most extreme views and vested financial interests.  If people realize that there are policies that can keep guns from dangerous people and save many lives and that those policies are supported by an overwhelming majority of gun owners, things could dramatically change for the better.

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

I met Leana Wen– she gave one the best talks that I heard.  Only months later, I was pleased to find that Dr. Wen had accepted the position of Health Commissioner of Baltimore, where I work. She has championed a public health program to reduce gun violence in Baltimore that is run out of the Health Department that I have been involved in evaluating. The program has helped to quell the violence that has taken over many Baltimore neighborhoods since May in the small number of neighborhoods where they are working.

What is the legacy you want to leave?

One of a scientist that has produced solid evidence to show that strong gun laws that are supported by the majority of gun owners save lives. And someone who respects gun owners and knows that that the majority of gun owners favor policies that research suggests would lead to many fewer lives lost.

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

I wish I could have mentioned my latest research findings that show that handgun purchaser licensing laws appear to have reduced homicides and suicides in Connecticut after it adopted such a law while increasing homicides and suicides in Missouri after the state repealed handgun purchaser licensing requirements.

What’s next for you?

I am continuing several research projects examining the effects of background check requirements and firearm restrictions for domestic violence offenders. In Baltimore, we are examining the effects of public health outreach and conflict mediation to reduce shootings, focused deterrence programs directed at those at highest risk for involvement in gun violence, and drug and gun law enforcement approaches.  I’m also deeply involved in studying policy solutions to the epidemic of overdose deaths due to prescription opioids and heroin.

Indigenous economic health: Q&A with Rebecca Adamson

On the TEDMED 2014 stage, Indigenous economist Rebecca Adamson, founder of the First Nations Development Institute and First Peoples Worldwide and a globally recognized advocate for the rights of Indigenous Peoples, shares how culturally appropriate, values-driven, sustainable development based on indigenous principles contributes to a new concept of health. We caught up with her to learn more.

What motivated you to speak at TEDMED?

Understanding health as an emergent property, and seeing the individual’s health as merely a part of society’s collective health, aligns closely with the holistic approach found within Indigenous Peoples’ worldview. This understanding provided me a natural bridge to make the case that the old medical paradigm that has operated until now with a single, limited, linear worldview needed rethinking. I wanted to show how much the Indigenous worldview has been literally and figuratively handcuffed and prohibited from use. Albert Einstein once said, “You can’t solve a problem with the same conscience that created it.”  I wanted to present how culturally diverse perspectives, especially Indigenous perspectives that emphasize the health of the community rather than the health of the individual, are compelling and relevant technologies for today.

Medical science has determined that healthy individuals emerge from a healthy relationship with a healthy society in a healthy ecosystem. This means that the distribution and delivery of healthcare must meet the needs of the whole society, not merely a part of it. For me, this is a game-changer. As a Cherokee Economist, with a lifetime invested in Indigenous development, my experience with western models has been that they focus on accumulation with little attention to distribution. One of the most crucial aspects of the emergent property of health is that well-being is achieved collectively, meaning that the distribution and delivery of our healthcare actually determines the efficacy of our medical system, our individual health, and the well-being of our society. I believe the Indigenous paradigm lends a new perspective in rethinking healthcare and the medical profession.

Rebecca Adamson at TEDMED 2014

“One of the most crucial aspects of the emergent property of health is that well-being is achieved collectively, meaning that the distribution and delivery of our healthcare actually determines the efficacy of our medical system, our individual health, and the well-being of our society.” Rebecca Adamson at TEDMED 2014

Why does this talk matter now?

Indigenous Peoples are still being handcuffed, figuratively and literally. We are being arrested, shot at and killed for our natural resources. This is going on at the same time that many of our sciences (not just medical) are uncovering the interconnectivity of life – all Life. Holistic worldviews are not exclusive to Indigenous Peoples but the millennia of empirical data on how societies can organize politically, socially and economically for sustainability is being lost. Right now there is an overemphasis on the technological and financial aspects of our society. As medical practitioners, you can really see it in the healthcare system. For example, if we know that health is an emergent property then why is so little or no attention given to the distribution and delivery of healthcare for all – not merely a portion – of society? Sure, we need technology and sure, we need to pay for it – but I wanted to challenge my audience to consider a new way of thinking about healthcare and medicine, one that encompasses society as a whole. Remember the distribution of the whale hunt in an Inuit village, compared to the distribution of cash in the same village? Could you imagine our society if healthcare were to be distributed with the same sophistication as the Inuit whale harvest?  However, if we were to map the distribution of healthcare services in our society today, I fear that it would follow the pattern of hierarchical cash distribution, as opposed to holistic asset or resource distribution, where everyone is accounted for.

The efficacy of traditional medicines is just one part of what Indigenous Peoples can offer the field of medicine. Because the Indigenous worldview is holistic, Indigenous Peoples are brilliant systems thinkers. Indigenous systems leverage and account for the inter- and inner-connections between individuals, community, society and even the ecosystem. Today, we are at a critical point of opportunity where changing the distribution of healthcare is imperative for changing the health and wellbeing of our society. An Indigenous paradigm that values the interconnectedness and interdependence of society can serve as a crucial guide in shifting emphasis from financial gain to collective well-being in the medical field.

What impact do you hope the talk will have?

Our healthcare system today is riddled with problems, that I see stemming from an exaggerated focus on the individual and neglect of the collective wellbeing. I hope my talk will lead TEDMED to focus on the importance of access, distribution and healthcare delivery with the same attention that it dedicates to technology, data and finance. The answers lie in alternative ways of understanding healthcare and medicine. TEDMED has a commitment to diversity that it demonstrated in this incredible gathering of experts, both in speakers and in the audience. I challenge you all to do more. Take the mental handcuffs off. Challenge paradigms that prevent diverse voices and perspectives, as they are the only way we are going to solve the complex issues facing us today. An Indigenous way of thought accounts for the collective – an individual is just one part of a community, just as a plant is one piece of an ecosystem. In the Indigenous paradigm, the health of the individual is dependent on the health of the community. I hope my talk inspires those in medicine to begin rethinking how they approach health care, and to begin considering how our current system can reach society as a whole rather than merely a part.

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

Ultimately, I wanted to leave the audience with this question: what do Indigenous Peoples have to share with TEDMED? Remember the distribution of the whale hunt – isn’t that, at its very best, the kind of distribution you would wish for today’s health delivery system? Can you imagine the preventative savings in a health system that reaches everyone? In a society where everyone is someone else’s mother, father, brother, sister, uncle, aunt, cousin… It is the entire society, not merely a part of it, that must survive.

What are some actions viewers can take in support of this cause?

In my talk, I challenged the audience to begin thinking about healthcare from an Indigenous perspective. Now, I challenge them to start working from that perspective – begin exploring how to make healthcare delivery reach the furthermost places in our society; how to begin emphasizing the health of the community over the health of the individual; and how to distribute medicine and healthcare so that it resembles the whale distribution map, and not the cash distribution map. I challenge medical professionals to imagine a society of collective prosperity and health, and to begin a collective discussion on how to achieve that dream.

Music Without Borders: Q&A with Farah Siraj

Farah Siraj, Jordanian singer and songwriter, has performed at the United Nations, Nobel Prize Hall, and World Economic Forum and had a #1 hit song in India. She shares her unique style of worldly music, a delightful Eastern and Western fusion.

Farah Siraj at TEDMED 2014

Farah Siraj at TEDMED 2014

What motivated you to perform at TEDMED?

It was a true pleasure performing at TEDMED. Also, the fact that we got to take the stage at the John F. Kennedy Center was a dream come true! Above all, what I love about TEDMED is that it is a platform for innovative, out-of-box thinkers to come together and share their ideas and discoveries with one another. It was definitely an eye-opening experience! TEDMED talks make you think twice about things!

What were a few TEDMED 2014 talks or performances left an impression on you?

One of the highlights of TEDMED for me was Diana Nyad’s talk. I find her fascinating— Diana is the perfect example of someone who didn’t give up on her dream, and how something can look impossible until you make it possible. There were so many odds against her each time she set out to sea, and yet that didn’t stop her. Diana’s talk was inspiring, charismatic and uplifting. When we met, I just had to give her a huge hug and tell her what an inspiration she is to me!
Dominick Farinacci’s performance was very inspiring. Music has profound healing powers and Dominick’s music is an example of that. Also, it’s great when an artist walks you through the story of their music, it gives you an understanding of where they were in their life when they wrote it. Great performance and great artist! We got to join our bands and create music on stage at the evening celebration, an experience I will always cherish.
I really enjoyed Rosie King’s talk. She talked about how autism is never a one-size-fits-all thing. It is a reminder of how far we still have to go in the field of understanding autism and providing the best support for autistic children and their families. Rosie was also an example of the brilliant intellectual abilities that often come with autism and are often overlooked. In the Middle East, autism awareness is finally taking off and my music was used in the first video campaign in Arabic to raise awareness about autism in the Arab world. It’s a cause I support wholeheartedly.

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

The fact that the majority of TEDMED attendees were in in the medical field led me to meet people so far out of my field. I loved it! I had lots of fun conversations with people and got to connect with some really inspiring people and make new friendships.

Farah Siraj at TEDMED 2014

Farah Siraj at TEDMED 2014

What is the legacy you want to leave?

I believe I was given the gift of music so that I could use it for the greater good: to help and heal others through music, and to inspire people to make a positive change in their lives and the lives of others. My hope is that fulfilling that mission will be my legacy, as well as to be remembered as someone who helped amplify the voices of others who needed to be heard.

Rethinking New Diseases: Q&A with Sonia Shah

Sonia Shah, an investigative science journalist and historian, challenges conventional understandings about the real causes of pandemics. We caught up with her to ask a few more questions.

Why does this talk matter now?

The way we understand the origins of new diseases shapes our response to them—responses that will become increasingly relevant in this age of emerging and re-emerging pathogens, from Ebola to cholera. This talk is based on my forthcoming book—“Pandemic: tracking contagion from cholera to Ebola and beyond.”

Sonia Shah at TEDMED 2014

Sonia Shah at TEDMED 2014

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

I met the comedian Tig Notaro, whom I’ve admired for a long time. We shared a table at a book signing—I did not expect that! I’m a science journalist!

How can we learn more about your latest work?

My book comes out in February 2016, and it’s available for pre-order now. I’ve also collaborated with the Pulitzer Center on Crisis Reporting to create an app called “Mapping Cholera,” which provides an interactive visualization and narrative about the 1832 cholera outbreak in New York City, which I spoke about in my talk, and the 2010 cholera outbreak in Port-au-Prince, Haiti. And you can find more updates at soniashah.com, too.

Music as Medicine: Q&A with Gypsy Sound Revolution

Gypsy Sound Revolution, led by drummer Cédric Leonardi and fellow Gipsy Kings alumni, mixes rumba with Indian raga. They play a unique fusion of Indo-Gypsy music that is both meditative and joyful. We followed up with them to learn more about their project.

"Music is borderless. It is the ultimate expression of love." Gypsy Sound Revolution at TEDMED 2014.

“Music is borderless. It is the ultimate expression of love.” Gypsy Sound Revolution at TEDMED 2014.

 What motivated you to perform at TEDMED?

As a performer, you want to reach as many people as possible with your art form. Music is increasingly accessible digitally and also thrives using many methods of delivery.
Somewhere along the way, it became a business. A big business. Performing at TEDMED was our way of delivering a message and access to the healing power of music. Music came out of the caves of India as medicine. Invoking the divine, but with a modern vernacular, we have seen lives transformed through the joy of our music. TEDMED was a potent forum to express this and continue the medicinal conversation globally, reaching as many people as possible.

What is the legacy you want to leave?

We hope our legacy shows the way for our children to live authentic lives, fully expressed and joyful using the path we have forged with our music. To touch the hearts of people and share the joy of living together on this planet. Music is borderless. It is the ultimate expression of love.

We cherish the poem, “What will matter,” by Michael Josephson, as a reminder of the fragility of life and the speed with which it passes:

Ready or not, some day it will all come to an end. There will be no more sunrises, no minutes, hours, or days. All the things you collected, whether treasured or forgotten, will pass to someone else.
Your wealth, fame, and temporal power will shrivel to irrelevance.
It will not matter what you owned or what you were owed.
Your grudges, resentments, frustrations, and jealousies will finally disappear.
So, too, your hopes, ambitions, plans, and to-do lists will expire.
The wins and losses that once seemed so important will fade away.
It won’t matter where you came from or what side of the tracks you lived on at the end.
It won’t matter whether you were beautiful or brilliant.
Even your gender and skin color will be irrelevant.
So what will matter? How will the value of your days be measured?
What will matter is not what you bought, but what you built; not what you got but what you gave.
What will matter is not your success, but your significance.
What will matter is not what you learned, but what you taught.
What will matter is every act of integrity, compassion, courage, or sacrifice that enriched, empowered, or encouraged others to emulate your example.
What will matter is not your competence, but your character.
What will matter is not how many people you knew, but how many will feel a lasting loss when you’re gone.
What will matter is not your memories, but the memories that live in those who loved you.
What will matter is how long you will be remembered, by whom, and for what.
Living a life that matters doesn’t happen by accident. It’s not a matter of circumstance, but of choice. Choose to live a life that matters.

What’s next for you?

Taking our music and message around the world in 2015. We are also finally going into the studio. We are very much a live band– we believe live interaction with people is the true purpose of music. However as TEDMED live-streaming proves, there are many more people that live streaming can reach in all kinds of obscure pockets of the world. The internet has brought us all closer so its time we stopped resisting and we have started to the process with the conundrum: how do you bottle magic? We will have at least three tracks recorded soon.

Any action items for viewers interested to get involved in the kind of work you do? How do they join the revolution?

We are starting a philanthropic initiative to support the communities of our Rajasthani musicians with a US based Indian company, HP Investments. The project will include music camps for children to keep the music traditions of this original gypsy tribe alive, as well as taking care of the necessities like water and power in their villages. Its a humbling and glorious experience working with musicians who go home to their villages without water and power after they have travelled the world with us. We are one– we have a responsibility to help each other beyond.

Artistic Humor for the Soul: Q&A with Bob Carey

Bob Carey is the photographer and subject of the “Tutu Project.” This series of stunningly silly videos and still self-portraits was originally launched to cheer up his wife, Linda, after she was diagnosed with breast cancer, and later went viral. He spoke about the power of humor to help cancer survivors.

Photographer and cancer activist Bob Carey at TEDMED 2014

Photographer and cancer activist Bob Carey at TEDMED 2014

What motivated you to speak at TEDMED?

Based on the viral nature of the Tutu Project and the impact it’s had, our goal has been to find opportunities to continue to share the images and story, and not only within the breast cancer community. I feel that it’s important to share creative ideas that use art and humor as a means to help live with the many challenges in life. When TEDMED asked me to speak, not only was I excited, I felt it was the perfect opportunity and audience to share my work.

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

It matters now as there will always be challenges in life– and inspiration can impact people every day. I hope that my talk will inspire others to see that there are many approaches–sometimes unusual, unexpected or creative– one can use to cope.

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

The speaker coaches were kind and compassionate, not that I wouldn’t expect that to a certain degree, but I bonded with them and with that, felt empowered to speak with my tutu on– a first for me. Another meaningful connection was with one of the speakers. The staff was wonderful as were the attendees. It seemed that although the subject matter was different, we were all looking for new and creative ways to approach problems.

The Rewards of Risk-Taking: Q&A with Kayt Sukel

On the TEDMED 2014 stage, Kayt Sukel, journalist and science writer, shared insights into the neuroscience of risk-taking and how play during childhood and adulthood impacts the way we make decisions as adults. We inquired for more on brains at play and her favorite TEDMED 2014 talks.

"Too often, we wrap ourselves up in our grown-up suits and avoid play at all costs. And that’s to our detriment—at work, at home and for our overall health." Kayt Sukel at TEDMED 2014

“Too often, we wrap ourselves up in our grown-up suits and avoid play at all costs. And that’s to our detriment—at work, at home and for our overall health.” Kayt Sukel at TEDMED 2014

What motivated you to speak at TEDMED?

I’ve found so much inspiration in many TEDMED talks—and learned quite a bit. As I’ve been working on my book about the science of risk-taking, there were so many things I learned that I wanted to share. I’m honored I got the opportunity to do so on the TEDMED platform.

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

More and more, Americans seem to live in a culture of cultivated busy-ness. We have so much to do that we forget to take time for ourselves. And while we understand that our kids need to play (and take risks as they do so) in order to learn and grow—many of us have forgotten how to play for ourselves. Too often, we wrap ourselves up in our grown-up suits and avoid play at all costs. And that’s to our detriment—at work, at home and for our overall health.

I hope that people will recognize that there is great value in play—not just for children but also for adults– and that they understand that taking risks in playful arenas is a great way to gain critical problem solving, cognitive and emotional regulation skills. I want them to understand that the things we do each day to cultivate health don’t have to be joyless and staid. So if the people who listen to my talk find some time to engage in some kind of play, push the envelope a little, and reap all those beautiful brain benefits, I’ll feel like I’ve done something important.

How can we incorporate play and risk-taking into our daily lives?

I encourage everyone to find something that motivates you—whether it’s learning a new language, taking an improv class or rock climbing. Then, push your limits. You’ll be surprised where risky play can take you.

Tell us about your favorite TEDMED 2014 talks or performances that left an impression with you.

I found the whole program to be tremendously inspiring. But that said, if I have to play favorites, I was bowled over by Jeff Karp’s talk on bio-inspiration. His work on finding inspiration in the natural world and then bioengineering it for modern-day use just blew me away. I would never have thought about translating the properties of porcupine quills into state-of-the-art surgical staples– nor would I have agreed to put said quills into my face as a test–but Jeff did! —and it was a pleasure to learn more about his research and the way he thinks about problem-solving.

Jeff Iliff’s talk on sleep and the glymphatic system was fascinating. I remember one of my own neuroscience professors discussing the mysteries of how the brain clears out its waste almost 20 years ago. It’s such a big question—and one that has implications for neurodegenerative disease. I love that technology has advanced to the point where researchers like Jeff and his colleagues are beginning to figure it out. Also, he reminded me that I really need to make sure I get my beauty rest!

And, finally, I enjoyed Sophie de Oliveira Barata’s talk on the Alternative Limb Project. In a former life, I was the wife of a military officer during Operations Iraqi Freedom and Enduring Freedom. In that role, I met far too many soldiers who lost limbs. While prosthetic technologies are wonderful, many artificial limbs can feel a bit blank and soulless. Her creations moved me. And they show that we can embrace our differences, even those that we did not choose for ourselves, and allow them to be just another canvas to show the world who we are inside.

But I feel like I’m leaving out other great talks and performances—like those by Leana Wen, John Cryan, Carl Hart, Danielle Ofri, Marc Abrahams, Sonia Shah, Cole Galloway, Heather Raffo and Farah Siraj. Really, I could go on and on.

What is the legacy you want to leave?

Our family motto is “experiences over possessions.” I hope that, over the course of my career, I’ll inspire people to explore, to connect, to laugh and to live as fully as they can. And that, of course, requires being open to both playing and taking risks.

What’s next for you?

I’m finishing up my forthcoming book about the science of risk-taking, The
Art of Risk: The New Science of Courage, Caution, and Chance. It hits
shelves March 2016.

Making New Waves in Anesthesia: Q&A with Emery Brown

Emery Brown, anesthesiologist, Professor of Computational Neuroscience at MIT, and Co-Director of the Harvard-MIT Division of Health Sciences and Technology, unveiled the surprising truth about exactly what happens to your brain under anesthesia and what it suggests for understanding the brain and improving treatment.

"Anesthesia works primarily through the production of oscillations that disrupt the way regions in the brain communicate." Emery Brown at TEDMED 2014

“Anesthesia works primarily through the production of oscillations that disrupt the way regions in the brain communicate.” Emery Brown at TEDMED 2014

What motivated you to speak at TEDMED?

When I had the honor to be invited, I realized that it would be a great opportunity to educate the public on general anesthesia and other practices in anesthesiology. The state of general anesthesia is viewed as a blackbox process by the field of anesthesiology, other fields of medicine and the general public. I was motivated by the importance of bringing an informed, modern perspective on general anesthesia to the lay public, the medical field, neuroscientists and anesthesiologists.

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

General anesthesia is viewed as a mystery both within as well as outside of medicine. After nearly 170 years of administering anesthesia in the United States, how anesthesia works is still considered as unknown and by some as unknowable. My research can change this because we can teach medical and lay communities that anesthesia works primarily through the production of oscillations that disrupt the way regions in the brain communicate. This disruption of communication is how the drugs make patients unconscious. These oscillations are readily visible in the EEG patterns of patients under general anesthesia. Different anesthetic drugs produce different patterns. The EEG patterns differ because different anesthetics bind to different targets in the brain and therefore produce oscillations in different circuits. All of these patterns are much larger and highly organized than the awake EEG or the EEG of people who are asleep. Therefore, anesthesia caregivers can learn to read these patterns and know whether a patient is appropriately unconscious to undergo surgery. Reading the EEG to monitor the brain states of patients under general anesthesia can be used to eliminate the frightening problem of awareness (waking up paralyzed). Dosing of anesthetic drugs can be more carefully titrated and the incidence of postoperative cognitive dysfunction and delirium will likely be reduced.

General anesthesia is a profound drug-induced reversible coma. A patient has to be in a state of coma, i.e. being completely insensate and unaware, in order to tolerate the traumatic insults required to execute most surgical procedures. Sleep is a natural state of reduced brain inactivation that is necessary for maintaining normal health. Sleep is defined by two primary states; non-rapid eye movement (non-REM) and rapid-eye movement (REM) sleep. The brain switches approximately every 90 minutes between the non-REM and REM states during natural sleep. The EEG under sleep and a person’s behavioral state (being readily arousable) show that general anesthesia is not sleep.
I hope my talk can provide an accessible forum for the lay public to understand, 1) how general anesthesia works, and 2) that this process which is used every day in millions of people around the world should no longer be viewed as a mystery.

Beyond the need to have general anesthesia for surgery and certain diagnostic procedures, the study of general anesthesia from a neuroscience perspective provides an essentially unexplored way to learn about the brain. This study may also lead to new therapies for treating depression, sleep disorders, pain and facilitating the recovery of patients from coma.

What is the legacy you want to leave?

I hope to have taught the public how general anesthesia works and made it possible for the public to understand that anesthesia is not a mystery. I used this knowledge to improve anesthesia care for the thousands of people in the US and the millions of people worldwide who daily receive general anesthesia and sedation to safely and humanely undergo invasive diagnostic and therapeutic procedures.

What’s next for you?

My next step is to change practice and research in anesthesiology. I will be setting up my Center for the Neuroscience Study of Anesthesia at Massachusetts General Hospital, where we’ll work to gain deeper insights into the altered states of arousal created by anesthetics; develop new neurophysiologically based EEG strategies for monitoring the state of the brain under general anesthesia and sedation; teach anesthesiologists and other anesthesia caregivers how to read the EEG in order to understand the brain states of patients receiving general anesthesia and sedation; develop new ways to precisely control the state of general anesthesia and sedation; study ways to rapidly bring patients out of the state of general anesthesia; create all new approaches to producing general anesthesia and sedation that are side effect free, particularly for children and the elderly; educate the medical professional and the public about how general anesthesia works; show that general anesthesia, when viewed from a neuroscience perspective, offers a new and virtually untapped way to learn about the brain; use knowledge gained from studying the brain under general anesthesia to devise new strategies to treating depression, new approaches to producing sleep, treating pain, epilepsy, autism and facilitating recovery from coma.

Any action items you want the viewer of your video to take?

I would appreciate knowing what viewers think about the work. It’s important for everyone to encourage greater funding for study of the neuroscience of anesthesia by federal and private funding agencies. The benefits will go well beyond simply anesthesia care. I also think that it is important that the public encourage the anesthesiology community to put in place guidelines and strategies to use the EEG to monitor the brain states of patients receiving anesthesia care.

 

The Sound of Health: Q&A with Julian Treasure

In his TEDMED 2014 talk, Julian Treasure discussed the importance of designing health care facilities with acoustic healing in mind. Now he’s shared a bit more about his talk, his time at TEDMED and his vision for the future.

Julian Treasure at TEDMED 2014

“We’re designing environments that make us crazy. It’s not just our quality of life that suffers. It’s our health, social behavior, and productivity as well.” Julian Treasure at TEDMED 2014

What motivated you to speak at TEDMED?

The scandal of noise in hospitals is unacceptable, affects millions – and is virtually unacknowledged by the profession. This must change!

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

I sincerely hope healthcare facilities take my three simple steps for good sound onboard because I am convinced they will transform outcomes almost immediately.

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

Meeting Bob Carey and his tutu… wonderful. And with a young baby we are passionate about breastfeeding, hearing E. Bimla Schwarz give the evidence for the benefits of this wonderful process.

How can we learn more about your work?

My fifth TED talk, How To Speak So That People Want To Listen, was released roughly a year ago and is now in the top 30 TED talks of all time. I have resources free and also links to my courses on conscious listening and powerful speaking on my website.

What is the legacy you want to leave?

Healthy sound in every building we occupy – and a world that sounds beautiful.