The limits of scientific certainty and the need for positive change

Michael Hendryx is a pioneering research investigator focused on the impacts of uneven environmental exposures faced by socioeconomically disadvantaged groups. In 2006, Michael started a research program on public health disparities for people in Appalachia who live in proximity to coal mining, with a focus on mountaintop removal. This research has shown that people who live close to mountaintop removal are at increased risk for a wide set of health problems including respiratory illness, cardiovascular disease, birth defects, cancer, and others. Michael spoke at TEDMED 2017, and you can watch his Talk here.


I have committed the last 12 years of my professional life to conducting research on public health conditions in Appalachian coal mining communities. I have focused in particular on a highly destructive form of surface coal mining called Mountaintop Removal. As I described in my TEDMED talk, mountaintop removal involves the heavy use of explosives to reach the buried coal, wholesale destruction of forests and streams, and production of water and air pollution over a large footprint in central Appalachia that is home to over a million people.

MTR site above a town. (Source: Paul Corbit-Brown)

As I write this blog, I am surprised to see these words on the screen: Appalachian coal mining has become a central part of my research career. I am not from Appalachia. I was born in Illinois and have spent most of my life in the Midwest and West. I knew very little about coal mining or its environmental, ecological, economic and public health harms before taking a faculty position at West Virginia University in 2006. But as I learned about the issue, and began to examine it from a public health perspective, I gradually became convinced that this mining practice was truly harmful to the health of nearby community residents.

In retrospect it may seem obvious that this is so, but the work faced two constraints: the impossibility of conducting the “perfect” study to establish definitive cause between mining and public health, and the doubt and resistance, not only from politicians and the industry (predictable) but from research colleagues who were sure (without actually studying the issue) that the health problems must be due to the usual suspects of smoking, obesity and poverty that plague mining-dependent communities. Certainly blowing up mountains over people’s heads couldn’t harm their health! Could it?

As I contemplated my TEDMED talk and considered the message I wanted to offer, I realized that I wanted to raise awareness about mountaintop removal throughout the TEDMED community, but I also wanted to say something to the larger scientific community that was not dependent on a single environmental issue, but that perhaps could aspire to a larger resonance. Initially, I wasn’t sure myself what this would be, but I knew it was something about the tension between science and advocacy, which morphed into a statement about the limits of science in the face of an ethical imperative. From someone like me who prides himself on the power of empirical evidence, this is quite a statement about scientific limits!

It’s a well-known idea in environmental science: the precautionary principle. If there is evidence that health is impaired, and if there is evidence of environmental risk that may reasonably contribute to that impairment, then appropriate action is necessary to reduce the risk even if all causal links are not understood.

Since 2006 I, with many co-authors, have published more than 30 research papers in academic journals that document environmental and public health conditions in mining communities. For me the answer is undeniable, despite the lack of the perfect causal study: mountaintop removal mining is harmful to public health. It should be discontinued to protect human health. I think we have reached the point where further studies are frankly unnecessary, except to keep the issue in the public eye. Additional studies carry the risk of doing a disservice to the people who live in these communities, as we can study the issue to death without ever convincing the politicians and industrialists who are motivated and rewarded by doubt. As I said in my talk, “There can always be doubt, if doubt is what you seek.”

Instead of continuing to document problems, it is past time to move to solutions. It is a fact that the physical reserves of recoverable coal in Appalachia are in sharp decline. It is a fact that the world is moving away from coal to other energy sources. Coal mining as an economic force in Appalachia is subsiding. This has nothing to do with a so-called ‘war on coal.’ It is a consequence of geological and economic reality.

The solutions, in my view, lie in the power, imagination and energy of the people of Appalachia. I have encountered many examples of efforts underway to promote a transition to a strong and sustainable economy for the region as coal approaches its death rattle. I anticipate that these incipient efforts will eventually lead the way to greater opportunity and health for the region. Vested political and economic interests still refuse to acknowledge or support the change, but eventually they will have no choice.

I found a narrative and that narrative became a song

 

Zoë Keating is a cellist and composer who put her music career on hold when her husband Jeff was diagnosed with stage IV non-smokers lung cancer. After Jeff passed away, it took Zoë time to start creating music again, but when she did, it became her lifeline. Zoë spoke about her experiences at TEDMED 2017, and you can watch her Talk, and hear her play the song “Possible,” here.


Four years ago my world exploded and disintegrated: my husband Jeff was diagnosed with terminal cancer, he died 8 months later and I became an only parent.

I spent a long time in a shell-shocked-limbo that I can barely remember (if I was weird to you during that time, I apologize!) and then I feel like I’ve been searching for the blown apart fragments of my life and trying to put them back together with tape but there are huge pieces missing and…what is the shape supposed to be again? I don’t know yet. It’s a process. I’m a process.

For the most part, I’ve been ok with that. But yeah, sometimes there is nagging voice in my head impatient for me to “bounce back”, “be resilient”, “overcome”, etc etc etc. It berates me to “get on with it”—whatever “it” is—so that then I can do the normal things that a successful artist does, like release a new album, something that seemed incredibly daunting in my new life.

So last year the folks at TEDMED invited me to speak. I thought about all the things I wanted to talk about. I could talk about the patient experience of health care. Or maybe I could talk about how I used to suffer from paralyzing stage fright until I discovered live looping—by recording short phrases of the cello and playing on top of them, I made a virtual cello orchestra to keep me company onstage and then I wasn’t afraid. I didn’t want to talk publicly about Jeff’s illness and death and what came after. I didn’t want to be defined by a story that was raw and painful and still bleeding.

I tried to write my talk about something else but as much as I didn’t want to be defined by loss, the biggest thing in my life was the gaping wound where my husband was. It would be insincere for me to give a talk about anything else.

So I started to write. I wrote iteratively in bits and pieces and as I wrote, a clearing appeared, and there was new music in it. As what I wanted to say crystalized into words, so did the music. I ended up making a talk and a song in parallel. In distilling my story, I found a narrative and that narrative became a song.

The act of finishing a single song made it seem possible for me to make another one, which I did after I gave the talk. And then I made another…

Zoë Keating, by Chase Jarvis

One theme running through all my music is the feeling of getting outside of things to get a bigger vista. I’m often looking for the musical equivalent of a bird’s eye view. It has been hard to get that kind of perspective of my life for the last few years. And frankly, it’s hard to imagine making something big, like an album, when you’ve lost your confidence, which I certainly had.

After I gave my talk, I could see that this process of looking at my personal story from afar, having an insight and then iterating on it, was very similar to how I make music. When I combine loops of cello together the resulting sounds and textures hint at new musical patterns to explore. When I wrote about what happened, thought about what I’d written and then refined it, the very process of doing that suggested new ways for me to think about it.

If I was to give another talk today, I might explore an idea I heard about during a subsequent performance that I had with Jad Abumrad, the founder and co-host of “Radiolab”. I was making live music for a talk he gave on the origins of the show in which he mentioned the idea of the “adjacent possible”, a term coined by the theoretical biologist Stuart Kauffman.

Bear with me for a second. Roughly, Kauffman’s theory as I understand it is that biological systems are able to transform into complex systems through incremental changes. Life didn’t start out complicated with something like a flying squirrel. First there were a bunch of carbon atoms, then those atoms combined to make molecules, then proteins, and then proteins made cells possible. Each step along the way created the possibility for the next step to occur, the adjacent possible. Kauffman’s idea has since been applied to social sciences, technology and creativity, describing how new insights can be generated by combining already existing ideas. The adjacent possible are the things made possible by what you are doing right now.

So for me, maybe the act of distilling my story at TEDMED created an adjacent possible for me, one where I’m able to make music again.

Here’s me talking about how music helped me think about life, love and loss, followed by a live performance of a new song called “Possible”. I’ll be releasing the studio version as part of a three-song EP on June 1.

Thank you, TEDMED.

Q&A with Agnes Binagwaho, Rwanda’s Former Minister of Health

In her 2017 TEDMED Talk, Rwanda’s former Minister of Health, Dr. Agnes Binagwaho, shed light on the experience of rebuilding Rwanda’s health system after the devastating 1994 genocide. We talked with Agnes to learn more about her past efforts and to find out what she’s working on today.


TEDMED: Can you describe some of the biggest challenges you faced as you began work to rebuild Rwanda’s health system? How did you overcome them?

Agnes Binagwaho: The biggest challenge I faced was figuring out how to do the most good and save the most lives with the extremely limited resources and infrastructure that existed, and beyond that, figuring out how to contribute to the growth of a system that would deliver the quality care I wanted for all children of Rwanda. Rwanda’s health sector was destroyed and there was a strong need for not just health professionals, but committed health fighters. We overcame these challenges by uniting as a country to determine the best way forward while still remaining true to our vision. We knew that if anyone was going to stand up for us, it was going to have to be us. We took that national commitment and leveraged it into a real transformation, a transformation in which our systems and our laws are mandated to serve the most vulnerable and to leave no one out.

TM: Have you seen Rwanda’s health system successes be leveraged in other countries? Have there been other unexpected outcomes that have emerged as a result of your work?

AB: In many places, similar interventions, policies, and practices are being introduced as the ones we introduced in Rwanda. Particularly around how, as a country, we are able to provide equitable, quality health care to all, and how to use ICT [Information and Communication Technology] in the management of the health system. Our health professionals often advise other national health sectors or organizations on the lessons learned in Rwanda and how they can be applied elsewhere. We are part of a global fight to make a healthier future and we are learning from one another so that we will all reach the SDGs.

TM: You are the Vice Chancellor of the University of Global Health Equity, which is unlike any other university we know. What is global health equity, and how do you teach it?

AB: At the University of Global Health Equity, our vision is a world where every individual – no matter who they are or where they live – can lead a healthy and productive life. We know that this vision is ambitious and that we will face a lot of challenges in its pursuit. We teach the values of accompaniment, compassion, commitment, and integrity to ensure a preferential option for the poor in health care. Our students are trained to connect with the communities most in need and to break down the barriers between academia and medicine and cities and rural or impoverished settings. They are trained to advocate for patients and to look beyond the traditional margins of health care and integrate a holistic view of health into practice and policymaking. At UGHE, we empower global health professionals to be leaders and managers and to use these tools to solve problems for those most in need, and to find lasting and inclusive solutions to the greatest global health challenges today.

Dr. Agnes Binagwaho leads a group discussion during the University of Global Health Equity’s Global Health Delivery Leadership Program, a certificate course conducted in partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria. Photo by Zacharias Abubeker for UGHE.

TM: What advice would you give young emerging leaders interested in politics and health reform?

AB: I would tell any young leader interested in this field to join us without hesitation, we need young and energetic thinkers to take up the fight for global health equity and to bring new ideas and innovative solutions to the health challenges of today and tomorrow. I would tell them to follow their dreams and to find what motivates them for public good. We need global health fighters that are passionate and outspoken advocates for those most in need. The field of global health is vast and multidisciplinary, and everyone has a role to play in ensuring access to quality health care for all. There is so much to do.

TM: What was the TEDMED experience like for you?

AB: The experience of the TEDMED talk was great; the scientific content was fantastic and spanned a variety of topics. I loved it; and I learned a lot. It was well organized and I felt really welcome in the community. It was also an occasion for networking with people with diverse experiences, but with the same goals, passions, and vision for a healthier future. I am grateful for the opportunity to come together with such great thinkers and advocates.

Ending the overdose crisis will not happen through prohibition

Written and submitted by Mark Tyndall.

Epidemiologist, physician and public health expert Mark Tyndall has dedicated his career to studying HIV, poverty, and drug use in multiple places around the world, starting with Nairobi, and now in Vancouver. Mark spoke on the TEDMED Stage in 2017, and you can watch his talk here.


We are now well into year three of an opioid overdose epidemic in North America. Drug overdoses are now the leading cause of unintentional deaths for adults between 20 and 50 years old, far out-stripping automobile crashes, suicides and homicides. In many cities, first responders now spend the majority of their time racing to the next overdose and filling emergency departments with overdose victims. While the loss of life is tragic beyond words, the impacts of this crisis go far beyond the individual and will leave families forever broken, communities torn apart and children with no parents.

Yet despite the ongoing crisis, we find ourselves stuck debating the most mundane issues and doubling down on the very policies that have created all this misery in the first place. Despite overwhelming evidence to the contrary, we cling to the belief that any programs designed to reduce the risk of overdose and make drug use less hazardous will somehow encourage people to keep using drugs, dissuade people from entering addiction treatment, make our neighbourhoods more dangerous, and entice our youth to launch into a career of drug use. Common-sense, evidence-based harm reduction interventions like needle distribution programs, supervised injection sites, naloxone distribution, methadone and buprenorphine substitution therapy, low-barrier supportive housing, and accessible residential addiction care are shot down as unacceptable, disruptive, risky and too expensive.

Apparently devoid of any new ideas, we fall back to our worst tendencies – demonizing drugs and the people who use them. The moral panic that is perpetuated in the media gives us cover to continue to stigmatize people who are using drugs and commit them to ever harsher criminal sanctions that all but ensure they can never recover. This is all based on some sort of magical thinking. Do we really believe that if only we punished and isolated people more that they would stop using drugs? Do we really think that taking society’s most vulnerable people and cycling them through the prison system is part of a recovery program? Do we really think that busting drug dealers reduces drug use?

It is clear that the upstream drivers of addiction – the poverty, the hopelessness, the trauma, the isolation, the violence, the physical pain and the mental illness – must be addressed. More people are in pain, more people are being left behind, and more people are using drugs to self-medicate. In such an environment, it is in everyone’s best interest to make drug use as safe as possible while we invest in the myriad of societal challenges that are driving demand. We need a whole different approach to drug use and addiction that recognizes that people will continue to use drugs as long as they feel that drugs are their best option. Pushing people with drug addiction to the margins of society by continuing to enforce drug policies based on crime and punishment just doesn’t make sense.

September 19, 2016, Vancouver, B.C. —Urban artist Smokey Devil’s work is prominent in the alleys of Gastown and the Downtown Eastside, most of them pleading with locals to take care of themselves in the wake of Fentanyl overdoses. Gordon McIntyre / PNG [PNG Merlin Archive]
There is no indication that the overdose epidemic will go away anytime soon. While many thousands of people have already died, it is clear that there are many more at risk. In many communities the street supply of opioids, which was traditionally dominated by diverted prescription opioids and imported heroin has been largely replaced by potent synthetic opioids – mainly fentanyl. In fact, in many places the chance of dying of an overdose today has increased from a year ago due to the worsening toxicity of the supply.

We urgently need a comprehensive approach to the overdose crisis that is built on reducing the upstream drivers of drug addiction while promoting proven harm reduction initiatives that reduce the adverse health effects of drug use, provide a crucial point of connection, and keep people alive. This will require a dramatic shift in the way we treat people who use drugs and removal of the perverse criminal sanctions that continue to ruin lives and perpetuate the overdose crisis.

To Whom Much is Given, Much is Expected: Why U.S. Should Lead on Global Health

Written and submitted by Senator William Frist, M.D.

Former Senator Bill Frist is a nationally acclaimed heart and lung transplant surgeon, former U.S. Senate Majority Leader, and chairman of the Distinguished Executives Council of the healthcare firm Cressey & Company. Bill spoke on the TEDMED Stage in 2017, and you can watch his talk here.


A life-changing story has been missed by the media and the general public. But it will be highlighted in the history books in future generations.

The story is that for less than 1% of our federal budget, the United States since 1990 has led the world in reducing by half those living in extreme poverty and halving the number of deaths of those suffering from AIDS, tuberculosis, and malaria. Moreover, we have cut in half the number of deaths of children under 5 through advancing vaccinations worldwide. And we have halved the number of deaths due to maternal mortality by training skilled birthing attendants and providing contraceptives for women. Our nation has forged the path with funding and infrastructure to tackle global disease, preventable deaths, and treatable illnesses to save the lives of millions.

Our legacy of global leadership was cemented in 2003 with the passage of the President’s Emergency Plan for AIDS Relief (PEPFAR), which I helped shepherd through Congress as Senate Majority Leader. PEPFAR provided an astounding $15 billion to fight AIDS across Africa and the developing world — more than any country or any President has ever committed to fight a single disease. Today, over 13 million people in developing nations receive life-saving antiretroviral treatment, compared to only 50,000 in sub-Saharan Africa when the program began.

Less well known but perhaps even more remarkably, PEPFAR has served as a powerful “currency for peace.” Countries that received PEPFAR assistance saw reduced political instability and violence, improved rule of law, increased economic output per worker, and improved views of the U.S., compared to similar non-PEPFAR regional countries. Our investment went beyond saving lives: it put nations on the track to peace and prosperity while improving America’s own national security and global standing.

Last year, the Trump Administration seemed to ignore decades of progress and shortsightedly recommended a draconian cut of more than 30% to our U.S. foreign assistance. Hope Through Healing Hands, a global health organization I founded 14 years ago, stood on the frontlines of advocacy with public health advocates, faith leaders, academic researchers, nonprofit leaders, and others who called on Congress to restore full funding for the international affairs budget. We sent letters with over 150 signatories, made phone calls, and flew leaders to Washington to share this message with members of Congress. We reminded elected officials of the critical importance of uplifting the world’s most vulnerable populations.

Thankfully, bipartisan champions in Congress, including Senators Graham, Boozman, Collins, and Murkowski to name a few, recognized the vital impact of these global health programs and responded with a 4% increase in overall funding. But a year later, those funds are once again under attack.

The Trump Administration has again recommended a cut this year of 30% to foreign assistance. We will be diligent in our advocacy, and steadfast in our support to continue the momentum of leadership in saving lives and ending extreme poverty in the midst of famine, conflict, and population growth. Not only because it’s the right thing to do, but because history will judge us on whether the U.S. maintained global leadership in global health and stayed the course… or relented to a national “Me First” philosophy.

Congress and the President just enacted a budget that increases funding for our military. Now let’s match that force of arms with the greatest strength the world has ever seen when it comes to medical mercy. Let’s practice the lesson of peace through healing. Let’s remember that rogue regimes and hateful fanatics are not the only threats to global peace.

Disease is a threat to peace. Pandemics are a threat to peace. Illness and hopelessness are threats to peace. And so, in a world facing all of these threats, now is precisely the wrong time to cut back on our modest funding for global health. To be blunt, you don’t go to war with someone who has just saved the life of your child.

Martin Luther King Jr. said, “Injustice anywhere is a threat to justice everywhere.” In our time, we’ve learned that a threat to health anywhere is a threat to peace everywhere.

We can bring more peace to the world and to ourselves, not only by deterrence – but also by compassion, by the power of healing hands, and by medicine as a currency for peace.

Announcing TEDMED’s 2018 Research Scholars

Preparing the TEDMED Stage Program is a year-long process, which begins the moment the first Speaker nominations come in. Each submission requires thorough research and careful consideration for how it might fit into the larger program. For help identifying the individuals and topics that will take the stage at our annual TEDMED event, we turn to the TEDMED Community—specifically our Editorial Advisory Board Members and Research Scholars—for their insight and expertise.

As a first step in the process, we rely on our Editorial Advisory Board members to suggest timely topics and themes that should be featured on stage and to provide their feedback on which Speaker nominations most embody the important work these topics and themes represent. Having completed four Editorial Advisory Board meetings and countless discussions following each meeting, the 2018 Stage Program curation process is well underway. While there is still work to do, we’re excited about how the program is shaping up.

Now comes the point in the process where we begin vetting the science and potential impact of each nomination. This is where TEDMED’s Research Scholars play a crucial role. The Research Scholars, a carefully selected group of passionate and objective individuals whose expertise spans the biomedical, public health, and emerging technology spectrums, help us to properly evaluate each nomination.

This year, we have selected 45 Research Scholars with specialties ranging from neuroscience to bioethics, digital health to nursing, and oncology to public health. We’re confident that the 2018 Research Scholars have the diverse backgrounds and breadth of knowledge that will allow us to take a deep dive into the complexities of this year’s Speaker nominations and to evaluate their suitability for this year’s program.

Our 2018 Research Scholars represent organizations and institutions including the Cleveland Clinic, Johns Hopkins University, the YMCA of the USA, Skoll Global Threats Fund, Icahn School of Medicine at Mount Sinai’s Loeb Center for Alzheimer’s Disease, GE Healthcare, the The University of Pittsburgh, the American Medical Association, and more.

Additionally, we’re excited to announce that we’re trying something new this year. We’ve partnered with Massive, a digital science media publication that brings together scientists and the science-curious public, and tapped into their pool of first-rate researchers to help us evaluate this year’s nominations. The TEDMED-Massive Scholars are members of TEDMED’s 2018 Research Scholars Program, and they are denoted by an asterisk in the list below. We’re excited about the TEDMED-Massive partnership, and we’re looking forward to sharing more over the coming months about how we’ll work together.

We are honored to announce this year’s TEDMED Research Scholars, and we thank them for their invaluable contributions.

Akash Chandawarkar, MD
Plastic Surgery, Medical Technology Innovation

*Anastasia Gorelova, PhD Candidate
Molecular Pharmacology, Cardiovascular Biology

Anna Pimenova, PhD
Neuroscience, Neurodegeneration

*Aparna Shah, PhD
Neuroscience, Pharmacology, Psychiatric Disorders

Beth Ann Swan, PhD, CRNP, FAAN
Healthy Communities, Health Care Delivery

Beth Taylor Mack, PhD
Health and Wellness Innovation

Boluwaji Ogunyemi, MD
Epidemiology, Dermatology, Medical Humanities, Health Advocacy

Bryon Petersen, PhD
Bioengineering, Stem Cell Biology

Camilla Engblom, PhD
Cancer Immunology

Christina Schweitzer, MPhil (Cantab), BSc, MD student
Medical Education

*Dan Samorodnitsky, PhD
Molecular Biology

Daniel Bu, BA, MD/MSCR Candidate
Health Care Delivery, Science and Technology

Danny Jomaa, MSc Candidate
Cancer Biology, Neuroscience

Diana Chen, MA, MD/MBA Candidate
Global Health, Healthcare Delivery, Marketing

Dilip Thomas, PhD
Tissue Engineering, Regenerative Medicine

Elisa L Priest, DrPH
Healthcare Quality, Epidemiology, Population Health

Elizabeth Rochin, PhD, RN, NE-BC
Maternal Health, Population Health, Patient Engagement

Emal Lesha, MD Candidate
Bioengineering, Biotechnology, Health Care

Emilie Grasset, PhD
Immunology

*Gabriela Serrato Marks, PhD Candidate
Climate Change, Science Communication

Gyan Kapur
Healthcare Technology, Genomics

*Irene Park, MS
Genetics, Science Communication

Jeffrey L. Blackman, MBA
Corporate Innovation, Entrepreneurship

Jennifer Olsen, DrPH
Public Health, Data Utilization

*Josh Peters, PhD Candidate
Quantitative Biology, Genomics, Infectious Disease

Joshua Brown, PharmD, PhD
Health Economics and Outcomes Research

Kaylynn Purdy, H BHSc, MD Candidate
Medical Education, Health Advocacy, Neuroscience

Kelly Jamieson Thomas, PhD
Cancer Prevention, Wellness Education

*Laetitia Meyrueix, PhD Candidate
Nutrition, Epigenetics, Public Health

Maria Papageorgiou, MSc, MBA
Market Access, HTA, Health Economics, Marketing

Meg Barron, MBA
Digital Health, Healthcare Innovation

*Melanie Silvis, PhD Candidate
Microbiology, Genetics, Genome Engineering, Antibiotic Discovery

Nicole Stone, PhD
Cardiac Reprogramming, Epigenomics

Paul Lindberg, JD
Public Health, Healthy Communities

Pierre Elias, MD
Cardiology, Data Science

Pramod Pinnamaneni, MD 
Oncology, Healthcare Innovation, Cost and Utilization

Raja R Narayan, MD MPH 
General Surgery, Medical Device Innovation

Regina Wysocki, MS, RN-BC
Nursing Informatics, Healthcare Information Technology

Shaahin Dadjoo, DMD Candidate
Dental Medicine, Craniofacial Development, Mindfulness

Steven Randazzo
Open Innovation, User-Centered Design

Tabitha Moses, MS
Bioethics, Medicine, Neuroscience, Public Health

Tanmay Gokhale, MD PhD Candidate
Biomedical Engineering, Computational Modeling, Cardiology, Entrepreneurship

*Yewande Pearse, PhD
Neuroscience, Gene Therapy, Stem Cell Therapy

Zuber Memon
Affordable Healthcare Technologies, Open Innovation

*Massive-TEDMED Scholar. Learn more about Massive at massivesci.com.

Simple Human Connections: Q&A with Sophie Andrews

In her 2017 TEDMED Talk, The Silver Line CEO Sophie Andrews speaks about how the best way to help another person is often just by being an empathetic listener. We caught up with Sophie to learn more about her efforts to foster human connections as a means to provide social connectivity for isolated senior citizens in the UK.


TEDMED: You begin your TEDMED Talk by sharing your personal story as a victim, and ultimately a survivor, of abuse. You turned to self-harm and other destructive behaviors as a way of coping. What would you say to someone who is suffering and doesn’t know where to turn?

SOPHIE: I’d say that you may not see it at the time but there is “life after…” and even though it will seem like there is no way out, there will be. Someone once said to me that nothing really bad or really good ever lasts forever and it’s true. Which means that you can survive and see the other side and there is help out there, although I realise more than most people that it’s hard to see the help at the time. I guess you need to be ready for the help to be able to receive it properly and that can take some time.

TEDMED: As a teenager, you relied on a helpline in a time of personal crisis, and you credit the service with saving your life. As an adult, you founded a hotline service, The Silver Line, for lonely senior citizens. In your opinion, what makes hotlines such a special form of support for people?

SOPHIE: For me it was the fact it was 24/7 and confidential—desperation doesn’t fit around a 9am to 5pm, Monday through Friday timetable. Plus I wanted to be believed and trusted and to still feel that I was in control. And the support I received, and the support The Silver Line provides, offers that.

TEDMED: What types of topics are your callers looking to discuss, and what trends are you noticing with the calls you are receiving?

SOPHIE: Significant loss—partner, loss of driving license, loss of mobility, loss of confidence—are all factors that can lead to social isolation. We are receiving increasing numbers of calls at night and weekends when other services are closed. Plus mental health issues, particularly overnight, when statutory services can’t cope with demand.

TEDMED: The people calling into the Silver Line are often suffering from feelings of sadness and isolation, but there also seems to also be a lot of joy on these calls and group chats. Can you share a story from a Silver Line caller that always makes you smile or laugh?

SOPHIE: I love the group calls where people talk about shared interests— we so often forget that for many people having a conversation with more than one person at a time is a rare occurrence. My favourite group is the music group where people actually play musical instruments down the phone to each other. There is a real sense of belonging amongst the group and lots of laughter of course!

TEDMED: In addition to the empathetic ear that Silver Line provides, what other services are needed in order to improve the lives of older individuals suffering from social isolation?

SOPHIE: It doesn’t have to be complicated—it really is about simple human connection. Technology has a part to play in modern life but there is a tipping point where technology can sometimes replace the human connection. How often do we send an email or SMS message rather than picking up the phone or visiting someone? I don’t necessarily think that we need new services—we just need to look out for each other a bit more!

TEDMED: The UK is taking loneliness and social isolation seriously, with funding and increased national attention including the appointment of a Minister for Loneliness. Does the Silver Line have plans to work with this ministerial office? And, what would you say to someone who said loneliness wasn’t a public health problem?

SOPHIE: We are members of the All Party Parliamentary Group on Loneliness which includes the new Minister for Loneliness. We speak with over 10,000 older people each week, so have an important part to play in terms of representing the voice of the older person and influencing at a national level. Loneliness is a public health problem because the cost of loneliness in terms of impact on health is proven and the impacts can be devastating (including increased incidence of chronic conditions and increased mortality rates). It is a problem that is potentially going to affect us all.

TEDMED: What are your predictions regarding the future of social isolation? As more people live longer, will they grow more isolated, or are we moving towards a more connected society for these populations?

SOPHIE: I worry that we are becoming less connected—social media gives a false perception of the number of friends we have and also sets expectations that everyone around us is somehow more popular as the information is visible for all to see. Yet in reality we are speaking to each other less and less, despite all the social media connections. The combination of an aging population and less social connection is a worrying one. We need to plan now for our retirements and think wider than just the financial planning—we need to plan ahead and invest in people and relationships now, outside of our work lives, so we have those strong investments in relationships for the future.

TEDMED: What was the TEDMED experience like for you? What advice would you have for a future Speaker?

SOPHIE: Terrifying! Exhilarating! Life changing! I’d recommend that you do it…if you are lucky enough to be asked. It’s a fantastic opportunity. I felt very supported and the people I met through the experience will always be remembered…and I’m keeping in touch with many of them too. Thank you for the opportunity.

Making Menstruation Matter

Written and submitted by Linda B. Rosenthal

Manhattan Assembly member Linda B. Rosenthal is a leading advocate on gender and menstrual equity issues in New York. Linda has passed more than 75 laws to improve the lives of all New York State residents, including a ban on the “tampon tax,” which eliminated the tax on menstrual hygiene products statewide. Linda spoke on the TEDMED stage in 2017, and you can watch her talk here.


Since I gave my TEDMED talk in November 2017, the fight for menstrual equity has taken center stage. As of today, 14 states do not tax menstrual hygiene products, and 24 others have introduced legislation to eliminate the tax altogether. The term menstrual equity has entered the common vernacular and become part of our collective consciousness.

I have spoken with period rights advocates from across the country and right here in New York who are fighting to ensure menstrual equity takes its place as a critical component of women’s health and want to model their efforts after our successful push in New York. I spoke at the first-ever PeriodCon, which was an electric gathering of activists who are making menstruation matter in every corner of the world.

And, it’s working. Lawmakers across the country are looking at menstrual health and equity issues for the very first time.

A number of states are now working on legislation, like mine in New York, to provide menstrual hygiene products free in schools and correctional facilities. Federal legislation would ensure that these products qualify for flexible spending accounts, among other things. Medical professionals are finally recognizing that dysmenorrhea is serious and can be debilitating for some, and there are efforts to consider new, more effective treatments for it. And, there is a move to make menstrual hygiene product ingredients available to consumers and to test product safety to better understand the health impacts of long-term use.

New York State included my bill to provide free menstrual products to students in secondary schools statewide in the proposed Executive budget, which means that we are a few short weeks from every student statewide having free universal access to menstrual hygiene products in school. This is a game changer for any young person who has ever felt ashamed because they did not have tampons when they needed one or because they could not afford them.

After my bill passed the New York State Assembly, New York’s correctional facilities voluntarily implemented a program to provide free menstrual hygiene products to people who are incarcerated. Once we pass my legislation into law, the program will remain in place permanently and preserve the health and dignity of menstruating individuals in correctional facilities for generations to come.

From 40,000 feet, it looks like we are on the precipice of a sea change here, and that’s because we are. People have finally begun to recognize that guaranteeing menstrual equity is a distinct and critically important component in the fight to protect women’s health.

Together, so many of us have worked to demystify and destigmatize menstruation, and now, we feel duty-bound to discuss menstruation and related medical and social issues to help make the change and achieve the equality that has for so long eluded us.

Even with our remarkable progress, it is not enough. Let’s be honest: it won’t be enough until tampons are treated like toilet paper.

Since giving my TEDMED talk, I have eagerly devoured every resource I could on this issue. And yet, I keep coming back to one: a 2013 TedX talk given by Nancy Kramer, where she argued that we must ‘Free the Tampon.’ She was right in 2013, and she’s still right today, five years later.

No one walks around with a personal roll of toilet paper for public emergencies or expects to put a quarter into a machine in exchange for a square of toilet paper in a public restroom. Tampons and sanitary napkins are not different than toilet paper. What is different, however, is the way we think about them and therefore, treat them.

Upon reflection, I realize now why it was so important that people heard me say blood and gush on the floor of the New York State Assembly. It’s the same reason it is so important that we each discuss our periods, freely and proudly. Every time someone mentions a period, we help break down the stigmas that have shrouded this natural function of our bodies and our health in mystery for years.

And because incremental change frustrates me, I have introduced legislation, the TAMP (Total Access to Menstrual Products) Act to require that every restroom in the State of New York – from fast food restaurants to colleges, to government facilities and office buildings – make menstrual hygiene products available in the same way they do toilet paper.

It is a matter of simple justice. At the foundation of movement toward menstrual equity is the recognition that menstrual hygiene products are necessities that have been singled out for historically biased treatment as a result of stigma and misunderstanding about the biological functions of half the population. This begins to end today, with the TAMP Act.

Seeking Artists In The TEDMED Community

This week, our Editorial Advisory Board kicks off a series of meetings designed to curate the topics, themes, ideas and stories that will shape the TEDMED 2018 program. As always, we will balance our review of the medical and scientific landscape with strong consideration of performance, visual arts, and narrative. We believe that scientific and artistic exploration ultimately share the same goal, which is to explain and communicate difficult concepts, and to create a deeper and more fuller understanding of ourselves, and the world in which we live. For this reason, art and design are an important part of the TEDMED program– to us, there is no clear division between science and art.

We’ve had some amazing artists who beautifully illustrate this connection between medicine and art from the TEDMED stage. For example, last year, cellist Zoë Keating shared how the emotions involved with her husband’s battle with cancer transformed her music, and how the artistic process has helped her heal and communicate her feelings more completely than she ever could through words. Visual artist Jennifer Chenoweth brought her XYZ Atlas project to TEDMED, and demonstrated how visualizing experiences and emotions can actually help communities become stronger and healthier.

A wide range of artistic talents join us each year, such as pianist Richard Kogan, painter Ted Meyer, fashion designer Kristin Neidlinger, art curator Christine McNabb, documentarian Holly Morris, improv performers Karen Stobbe and Mondy Carter, chef John La Puma, photographer Kitra Cahana, musician Gerardo Contino, and many more. And more broadly, storytelling itself is an artform. Every speaker from all backgrounds carefully craft their talk to share a unique gift with the TEDMED community. Every talk is therefore a piece of art the speaker shares with the audience.

And quite literally, our speakers themselves become pieces of art, because an important part of our event design each year is to work with artists who create portraits of our speakers. From widely acclaimed figures like Hanoch Piven and Victor Juhasz, to a collaborative project created by several RISD art students, to the fantastic work of Gabriel Gutierrez and Lauren Hess who were chosen from our community, we’ve been lucky to work with amazing talent. These artists are invited to TEDMED and become an important part of our Delegation. Find out more about their beautiful work here.

LOOKING FOR THIS YEAR’S ARTIST
Again this year, we’re excited to begin a search for the artist or artists who will help us bring this year’s speaker portraits to life. As part of our search, we’re officially accepting artist nominations and applications for TEDMED 2018.

Just as every year, our chosen artist or artists will join our community for 3 days in Palm Springs, CA at the La Quinta Resort and Club, November 14-16 for TEDMED 2018 (travel and accommodations covered by TEDMED).  If you are interested, or know someone who might be, read on!

ELIGIBILITY AND TIME FRAME
This call is open to amateur and professional artists, and all art mediums will be considered. While not required, the artist would ideally have a close tie to health and medicine. This could take form in the following ways:

  • Experience in the medical community
  • Experience working with patients
  • A personal story connecting the artist to health and medicine

ABOUT THE PROJECT
The artist will need to produce roughly 50 portraits over the course of the next few months. Illustrations will be based on reference photos that will be provided. Final portraits will need to be delivered as high res digital files based on our specifications.

The work will take place between March – July 2017.

HOW TO APPLY
To apply (or nominate an artist), please send an email to art@tedmed.com. Be sure to include a work sample, a brief bio, any relevant links, and details about the best way to get in touch (email, cell, etc.). If the artist is a good fit, someone from our team will reach out.

Application deadline: Midnight, March 12, 2018.

Panther Senses: How Racial Literacy Makes It Possible for Our Children to Keep Belonging Without Having to Fit In

Written and submitted by Howard Stevenson, Ph.D..

Howard C. Stevenson is Director of the Racial Empowerment Collaborative (REC). Howard is also the Constance Clayton Professor of Urban Education and Professor of Africana Studies at the University of Pennsylvania’s Graduate School of Education. Howard spoke on the TEDMED stage in 2017, and you can watch his talk here.


Imagine someone walking up to your 12 year old while they are styling down the street, playing in the park, or simply listening to music. To you, these are the daily experiences of childhood. To your child, these are behaviors of belonging in the world. But what if the person who walked up to your 12 year old saw your child as a thug, assumed the toy they were holding was a weapon, misjudged their cultural styling as a threatening move and assaulted their bodies, history, knowledge, identity, beauty, freedom, and genius in self-defense?

For parents of Black and Brown children, the stress of wondering if our children will come home safely is debilitating. We cannot always trust authority figures to act humanely toward our children. Our worry about their safety disrupts the ground we walk on. Moreover, not all parents have to fear that their children will be racially profiled. Racial threat research suggests that adults over-react to the ways boys and girls of color speak their minds and physically move. When racially threatened, adults perceive children and adults of color as older, larger, and closer than they really are. When authority figures over-react, they protect themselves first and too often make the most punitive “in-the-moment” decision toward youth of color.

What is the emotional cost for youth and adults of being exposed to repeated disrespectful attitudes, social interactions, and false accusations? The more Black and Brown youth experience subtle or blatant racial rejection from society and within schools, the less they feel safe, trust others, get peaceful sleep, or perform well at school.

Some parents try to teach their children to fit in and assimilate so as to not appear different and garner any negative attention. Be pretty. Some prepare them explicitly for potential racial hatred. Be on guard. Others still prefer to not “racially burden” their children, hoping they won’t face trouble. Be invisible. Unfortunately, a lot of “don’ts” lurk close by, like “don’t be angry” or “loud” or “too Black.” What is a parent left to do? Teaching racial literacy—or the ability to read, recast, and resolve racially stressful situations—can be one answer.

It’s like panther senses. Did you know that panthers have sensitive whiskers that help them navigate darkness? What if young people of color could learn to trust their panther senses before, during, and after these situations and learn to “be you?”

Racial literacy involves teaching youth of color to appreciate their cultural genius and discern racial support and rejection (read), reduce the stress of that rejection (recast) so they can make healthy decisions that benefit their well-being (resolve). Neither a cure for discrimination or a last ditch survival strategy, racial literacy skills can be a healing response to daily racial microaggressions.

Our research at the Racial Empowerment Collaborative shows that the more parents or children report socialization about negotiating racial politics, the better they report improvements in self-esteem, anger management, depression, and academic achievement. However, not all the racial conversations parents report yield positive results. The more children reported their parents socialized them to fit into mainstream society, the higher their depression scores. Why? We think it’s because many of the environments our young people of color enter don’t appreciate their difference.

Howard and the REC team.

Racial literacy can also be applied to the school environment. When harassed at school, students of color struggle to see the benefits of trying to fit into hostile social networks for the sake of future social mobility. We believe racial literacy at school is more likely to lead to more positive health outcomes because it 1) affirms Black and Brown youth’s accurate discernment of societal hostility or support; 2) reframes any racial rejection as the haters’ problem, not theirs; and 3) promotes them to embrace their genius and not question their potential. Once youth of color embrace their differences and the healing benefits of their culture, they develop confidence to engage rather than fight, flee, or freeze in the face of discrimination.

But without practice, none of these literacy skills become instinctual, like panther senses.

If “belonging” is the acceptance of my difference and competence, and “fitting in” is the dependence on other people’s acceptance of me, then why am I not questioning that acceptance if it’s rooted in inferiority? For many youth of color, “belonging” is to “fitting in” what “being myself” is to “pretending.”

Parents can’t always be there to protect their children from racial discrimination, and life offers no guarantees for our children. But we can equip them with the cultural tools to belong within whatever context they inhabit. Additionally, we can encourage them to choose to make healthy decisions around whether to accept or challenge other people’s perceptions of their difference and their potential. Be you.