There’s Hope in Our Mortality

Hope is defined as a feeling of expectation and desire for a certain thing to happen. So when we tell you that several TEDMED 2018 Speakers have taught us how to find hope in places such as serious illness and end of life, you might be surprised. Despite the initial discomfort of discussing such difficult topics, there is much to learn from conversations around end of life and cancer diagnoses. Whether it be through sound, support, or a little bit of humor, each of these Speakers has a unique approach to what it means to take on the challenges that life brings us with hope , and their insight can help us learn to become more comfortable and capable of having those difficult, yet critical, conversations about what it means to truly live.  

With a focus on making every moment of our life, down to our last breath, comfortable and full, Steve Pantilat, Chief of the Division of Palliative Medicine at UCSF, works on transforming the healthcare system to improve the quality of life for people living with serious illness and their families. Steve has spent much of his career focusing on how to preserve dignity in some of life’s most vulnerable moments, such as finding better ways to care for people in hospice. As the founding director of the national Palliative Care Quality Network (PCQN), a learning collaborative focused on how to improve palliative care across health care, Steve is creating new ways for doctors and hospitals to collaborate around providing comfort and hope to those living with serious and terminal illnesses. Steve has published over 100 peer-reviewed scientific papers, including one documenting how to set up similar networks to PCQN. While the conversation about death is a critical one to have, Steve’s doing important work to ensure that each person’s wishes are honored during their most vulnerable and difficult times in health care.

While Steve is designing resources for physicians, Yoko K. Sen is designing new hospital experiences for patients. As an ambient electronic musician, Yoko is tuned into sounds in ways that most of us are not. This acute sense was overstimulated when she was admitted to a hospital in 2014 and bombarded with harsh noises from various hospital equipment. This pushed her to ask the question: How do these disturbing sounds impact a patient’s wellbeing and dignity? This question inspired her to found Sen Sound, which not only looks at the impact that alarms and monitors have on the patients in a hospital but also how they affect the hospital staff. Yoko investigated these questions further as the artist-in-residence at Johns Hopkins University’s Sibley Innovation Hub. Turns out, with alarms going off constantly, physicians and patients develop “alarm fatigue” where they stop noticing the alarms altogether. Her effort to redesign the soundscape in hospitals is not merely about eliminating sound but designing the right sound experience for each person. Projects such as My First Sound and My Last Sound think about how to use the hearing sense to provide the best and most positive holistic experience for our most vulnerable populations at the ends of the spectrum of life.

At 34, Kate Bowler was a historian at Duke Divinity School and published author of the “first history of the [American Prosperity Gospel] based on divine promises of health, wealth, and happiness.” A year later, she was diagnosed with Stage IV cancer and confronted with the irony that was being an expert in the idea that good things happen to good people while facing serious illness. Channeling the mixture of emotions that come with such a diagnosis, Kate launched a national conversation about the discomfort we experience while talking about suffering to help not only herself but all of us learn to find hope and comfort in difficult conversations. Often using tongue-in-cheek titles for her articles and books, Kate finds ways to infuse humor into the serious discussions around pain and suffering, helping the reader engage with the difficult content. Aiming to ask the tough but necessary questions such as “What does the suffering person really want?” and “How can you navigate the waters left churning in the wake of tragedy?”, Kate wrote another book, Everything Happens for a Reason (and other lies I’ve loved), and currently hosts a podcast “Everything Happens”. On her show, she interviews guests about topics such as communication, love, and loss when facing illness and death, showing us how to be more comfortable talking about pain.

Whether it be the beginning or end of life, we all wish for our loved ones, and ourselves, to find dignity in the process. Sometimes that means embracing difficult conversations to know what ones’ last wishes are, and other times that means providing support for physicians to provide more options for those suffering. It can include redesigning our sensory experience of a hospital or developing a hospice plan that includes support for all the family members impacted. These Speakers are teaching us how to find hope and beauty in difficult situations and paving the way through what often feels like a dark forest of uncertainty. Be sure to tune into TEDMED 2018 next week, whether in person or online through TEDMED Live, to hear more about their unique perspective on what care can look like in the rawest moments.

A Culture of Health captured in fiction

The Robert Wood Johnson Foundation (RWJF) works with organizations across the United States to build a healthy future where everyone has the opportunity to live their healthiest life possible. RWJF calls that vision: a Culture of Health. Each year, through our partnership with RWJF, TEDMED has been able to share with the TEDMED Community some of the ways in which that Culture of Health vision is building momentum and influencing change.

This year at TEDMED, the Foundation is giving the TEDMED Community a sneak peak of a forthcoming anthology of short stories by some of today’s most thought-provoking futurist and fiction writers. This inventive book, titled Take Us to a Better Place: Stories of Health, Hope, and Healing, offers a creative way for readers to imagine what a healthy future might look like. The stories explore some of the opportunities and risks that reside in that future.  As Michael Painter from RWJF observed, “The invitation to these amazing writers was a broad one, without real requirements. Well, just one: use your imaginations and make us think. Help us imagine what a Culture of Health might be.”

We are excited that the Foundation is sharing a glimpse into this imaginative look at a future Culture of Health. Not only will we learn more about six of the stories, but we will meet five of the short story authors. The five authors will be with us this year to provoke conversation about the topics and themes of their stories. Below, we’re teasing you with just a bit about each of the stories we will share at TEDMED this year – we hope they spark some inspiration about a Culture of Health! If you’re joining us at TEDMED this year, we can’t wait for you to meet the authors, engage in conversation about their work and visions, and read a preview of their story.

Take Us to a Better Place: Stories of Health, Hope, and Healing will be released Spring 2019. Sign up to explore this collection of new, original stories:

“The Flotilla at Bird Island,” Mike McClelland
“The Flotilla at Bird Island” is set in near-future Atlanta, a city plagued by rising temperatures and large racial and financial divides. The ice caps have melted, leaving Atlanta as the most significant city in the Eastern United States and the capital of the “New Coast.” Every Atlantan carries an inhaler, wears protective jumpsuits and surgical masks, and requires a monthly cocktail of injections to fight the waves of new, aggressive diseases that have appeared as a result of the hotter, wetter world. But, on nearby Bird Island, life of all kinds is thriving, showing what is possible.

“Brief Exercises in Mindfulness,” Calvin Baker
“Brief Exercises in Mindfulness” is the story
of a group of recent college graduates
who have moved to Brooklyn and the
long-term residents they have displaced.
The story revolves around an apartment occupied by Dean, a fledgling technology entrepreneur, consumed by the ambition
to succeed at all costs, including his own
well-being, and his roommate Harry, a
public school teacher torn between the
desire to be of service to the world and his own neuroses.

“Return to Omelas,” Nayomi Munaweera
“Return to Omelas” is Nayomi Munaweera’s response to the questions raised in the legendary writer, Ursula K LeGuin’s famous short story “The Ones Who Walk Away From Omelas.” LeGuin’s story imagines a utopian society in an unspecified country. Every citizen lives free of the slightest sorrow; their lives are without sadness. Yet each of them knows that this perfect happiness is based upon the absolute suffering of one of their own. A child has been locked up in a dark room. The child is meant to suffer, and it is the reason for the city state’s perfect happiness. How long can it continue?

“Paradise,” Hannah Lillith Assadi
“Paradise” is a story about Rita, a
Syrian refugee, who lives in a low-income housing complex in Phoenix, Arizona with
her father and older brother. Before the story begins, Rita’s mother was killed in Aleppo
and Rita is plagued by troubling visions at night. Before going to bed, Rita often tries
to visualize paradise, following from a
proverb her mother often said to her about paradise residing beneath the feet of
mothers, but rather than paradise, Rita sees visions of the war.

“Viral Content,” Madeline Ashby
When Tacoma, Washington’s local high school football star, Tyrone Weathers, dies of an unknown illness, Glory, a young reporter, is determined to identify the cause of his death and inform the community. In her mission to report the story, Glory finds herself competing with special interests – the local sports culture, monopolistic media outlets, and capital – to cover this potentially deadly disease before it spreads any further. Glory persists in her investigation despite the challenges she faces, and she discovers that the source of the illness that took Tyrone’s life is a secret darker than any she could ever imagine.

“The Sweet Spot,” Achy Obejas
As if managing the day-to-day responsibilities of work and two young kids isn’t stressful enough for married couple Isa and Louise, a lover appears on the scene, Esther. Told from Isa’s point of view, “The Sweet Spot” by Achy Obejas traces the erosion of a once strong romantic relationship in a way that mirrors Isa’s gradual loss of hearing.

The Spread of Disease

It’s no secret that we humans are a pattern-seeking species, trying to organize the chaos that is our universe, our planet, and possibly our closets. This powerful ability allows us to make predictive models of all kinds, shapes, and sizes, unlocking the understanding of how things grow, survive, and deteriorate. This week we’ll be focusing on how scientists and innovators have applied these predictive skills when looking at how disease spreads across a species in order to best predict, or prevent it. Whether it’s geo-mapping zoonotic viruses or the fluid dynamics of a sneeze, you are sure to learn a thing or two at TEDMED 2018 about how pattern recognition could be our best shot at preventing the next pandemic.

With the recent outbreak of Ebola in the Democratic Republic of Congo, we are once again reminded just how vulnerable humans are to viral threats. It’s with these types of threats in mind that leaders gathered to form the Global Virome Project (GVP), an innovative partnership to detect the majority of our planet’s unknown viral threats. Partners are working to develop a global atlas of these threats, with a goal of identifying and characterizing 99% of zoonotic viruses within 10 years of its inception in 2016. With an approximate 1.6 million viral species yet to be discovered in mammal and bird populations, there is much work to be done. Patterns will likely emerge as the map gains more detail, and thus the security system of prevention for these potential epidemics will increase in strength. Thanks to the work of Jonna Mazet, Anchor Author of the GVP, and her team, we can look forward to a future that will be focused more on prevention, and require less reactive treatment.

Mapping viruses are tricky for many reasons, one of which is animal populations shifting geographically. With the average global temperature on the rise, a lot of animal populations are disappearing in some locations, or migrating to new homes, and bringing their zoonotic viruses with them. Daniel Streicker, Senior Research Fellow and head of the Streicker Group at the University of Glasgow Institute of Biodiversity, is working to anticipate and prevent infectious disease transmission between species. Daniel is using patterns from the data of longitudinal field studies in wild bats to forecast how a disease like rabies could spread, giving the government the information they need to take preventative actions.

While it takes a bite for a vampire bat to spread rabies to humans, there are many diseases that spread through fluid transmission. Lydia Bourouiba focuses her research on exactly how fluid dynamics impact disease transmission by finding patterns in events like a human sneeze or cough. As the director of the Fluid Dynamics of Disease Transmission Laboratory at MIT, Lydia combines multiple disciplines to analyze pathogen transmission in humans, animals, and plants. Through their research, her team is developing models that improve our understanding of pandemics, and ultimately finding new ways for us to improve prevention and preparedness. By taking a close look at how a splashing droplet radiates its splatter, her team is able to see how much coverage a droplet of pesticide gets on a leaf. Prior to their work, studies of this kind were focused on more steady configurations, like water from a faucet. By looking at unsteady configurations, like sneezes and sprays, Lydia and her team are helping us to better understand the dynamic process of disease transmission.

Playing with fluid dynamics in a different way, Hive Innovator David Hoey and his team at Vaxxas are developing an advanced platform for needle-free vaccine delivery. Based in Australia, Vaxxas has run clinical trials of their Nanopatch™ technology to deliver vaccines, including one for Polio. While the format is revolutionary, using an ultra-high-density array of short projections to deliver the vaccine to the immune cells immediately below the skin’s surface, that’s not the only incredible aspect of this technology. By packaging the vaccine in the Nanopatch™, they have also made the vaccine shelf stable without refrigeration for more than a year at room temperature. This breakthrough solves one of the greatest challenges remote areas face with vaccines: the high cost of refrigerated transport of these life-saving serums. With their outstanding work, the team at Vaxxas is providing hope that we will one day be able to prevent and stop epidemics and pandemics.

Whether it’s by researching fluid dynamics like Lydia, or documenting the geolocation of the world’s zoonotic viruses like Jonna, it is clear that patterns are the key to preventing the spread of disease. Once we find those patterns, like Daniel did with bat migration, we are able to be smarter about vaccination resources and threat awareness. Fueling efforts for smarter preparedness are companies like Vaxxas, who is working to discover new ways to design vaccines in order to provide protection for the world’s most vulnerable populations. We hope you will join us at TEDMED 2018 to learn more about these fascinating Speakers and Innovators and their work to understand and prevent the spread of disease.

Communication Build Up and Break Down

The nervous system is the information highway of our bodies. So, what happens when there’s a traffic jam, or a rogue traveler refusing to go with the flow? This week’s Speaker Spotlight will focus on those who are working to understand how this system works, and what happens when it doesn’t. Communication in the nervous system is dynamic, ranging from electrical signals to the transfer of genetic material, and the communication can come from some unlikely places, like our gut. This communication is critical, and when it breaks down, we see a variety of ailments and illnesses emerge. The question is, how can we stop this communication breakdown?

A good place to start is to establish just how our neural network communicates. Jason Shepherd, an associate professor at the University of Utah, studies how the brain stores information, as well as how these processes can malfunction due to neurological disorders and age-related cognitive decline. Jason and his team at Shepherd Lab have discovered how Arc, a neuronal gene protein that is critical for long-term memory and synaptic plasticity, is able to form viral-like capsids capable of transporting RNA. Jason sees that the larger implications of this discovery could transform genetic engineering and gene therapy, as many gene therapies often use viruses foreign to the human body, and this protein is native to it. As we learn more about how our nervous system transfers information, we remain hopeful that scientists like Jason will be able to find ways to prevent the communication breakdown from occurring.

When blood flow in the brain is disrupted, leaving the neural communication system without oxygen, a communication breakdown occurs. This can have devastating effects on a person’s life, making stroke prevention and treatment critical for our internal information interstate. According to the American Stroke Association, stroke is the fifth-largest cause of death in the United States, killing nearly 130,000 people a year. It is also a leading cause of long-term disability and the leading preventable cause of disability. Inspired by the loss of a patient who would have benefitted from more immediate care, Chris Mansi and his team at got to work developing an artificial intelligence (AI) platform to dramatically reduce the amount of time it takes to detect and triage strokes. Using machine learning software to evaluate brain scans,’s technology is getting critical patients into treatment faster. In February 2018, the FDA granted a de novo clearance for Viz LVO, the first-ever computer-aided triage and notification platform. Most recently, announced its second FDA clearance for Viz CTP through the 510(k) pathway, offering healthcare providers an important tool for automated cerebral image analysis. While the brain is getting choked by a blood clot or bleed, has found a way to improve the communication system outside the body to treat it.

Sarkis Mazmanian, the Luis & Nelly Soux Professor of Microbiology in the Division of Biology and Biological Engineering at the California Institute of Technology, is looking at how unlikely systems are interacting with the nervous system and impacting brain function. With the majority of research for neurodegenerative diseases, like Parkinson’s Disease, focusing on the brain, Sarkis has turned to the gut, looking specifically at the microbiome and how it communicates with the brain. There are a variety of ways in which scientists are studying the relationship between the gut and Parkinson’s, as well as Alzheimer’s disease. Sarkis focuses on how the specific microbes in a person’s gut can impact the brain. In addition to researching how the gut microbiome impacts our nervous system, Sarkis has done extensive research on the relationship between the gut microbiome and the immune system focused on answering the question: why are these bacteria not attacked by our immune system? Sarkis’s team found that the immune response to these bacteria actually benefits both the bacteria and the host. With his most recent published work focused on how the gut microbiome impacts locomotor behavior in fruit flies, Sarkis continues to deepen our understanding of how our microbiome communicates with our bodily systems.

While a good diet and proper sleep are good for everyone, they can be especially impactful for those who may be prone to Alzheimer’s disease. Zooming out of the microbiome and zooming back into the brain, Padideh Kamali-Zare created computational models to understand the role cell structures play in their function during her PhD studies in Sweden, and she has applied this learning to how Alzheimer’s progresses in the brain. At Darmiyan, Padideh and her team are developing software that can detect Alzheimer’s disease up to fifteen years before symptoms of cognitive decline. Using just regular brain MRI scans, Darmiyan produces maps and scores that can detect the progression of the disease. With early detection, they aim to dramatically change lives and therapeutic development, including incorporating the best candidates for clinical trials in new therapies. By alerting individuals earlier about the potential onset of Alzheimer’s disease, Darmiyan’s technology can empower them to take steps to delay cognitive decline.

Today’s healthcare system places a heavy emphasis on healing the body, but often less so on healing the mind, leading to mental health issues that slip past doctors unnoticed and untreated. And where a mental health need is detected, physical care providers are often disconnected from our outnumbered mental health professionals, making care coordination and referral difficult, at best. Quartet Health is focused on bridging this divide, by providing primary care providers with the technology and tools to identify patients who need care. To do so, Quartet connects primary care providers with four key stakeholders: patients, behavioral health clinicians, medical health providers, and payers. Robert Accordino, Chief of Behavioral Health at Quartet, will join us in Palm Springs to share the exciting potential of Quartet’s approach that connects care of the body with the care of the mind.

Yuri Maricich and his team at Pear Therapeutics are taking a radically different approach to treat matters of the mind. By literally reshaping how we think about therapeutics, Pear has found a way to treat substance abuse, mental disorders, and neurodegenerative diseases—wherever and whenever. Based on the premise that software not only has the power to change behavior, but can also change brain function, Pear created their first app, reSET, to help treat patients with substance use disorder. reSET, a Prescription Digital Therapeutics (PDT), is the first of its kind to receive FDA approval, distinguishing it from the 10,000 other apps that may show up when you search the App Store. Through their work, Pear is finding new ways to repair the brain’s communication system while also providing a better communication system between patients and doctors.

While there is still much to learn about how the human brain functions and communicates, it is clear that we are making significant progress. Whether that is identifying Alzheimer’s disease earlier or improving how we provide treatment for mental health conditions, there are many ways that scientists, researchers, and entrepreneurs are improving our understanding of our body’s vast information highway. With improved understanding, we also are able to develop better technologies and treatments for diseases and disorders of the brain. These exciting discoveries in how the brain functions, as well as innovative ways to treat brain diseases, are shining a light toward a healthier future.

The World Around Us

Nature has arguably been the most consistent source of inspiration for the human imagination, sparking curiosity and wonder. It also inspires us to think about the digital environment that now exists, although not necessarily considered natural, it is becoming more and more integrated into our daily lives and decisions. How can we use the environment, whether natural or digital, to improve our health? And what are we putting into the environment that is negatively impacting our health? This week’s Speaker Spotlight will focus on Speakers and Hive Innovators who have creatively thought about these questions, from biophilic buildings to how noise could be the next public health crisis. Regardless of their answer, each one has found creative ways to think about the input and output of humans’ complex relationship with our environment.

Would you be surprised if we told you that something as simple as having a window with a view of nature in your office can increase job satisfaction and decrease job stress? Award-winning architect Amanda Sturgeon designs with this concept in mind: the more we create a symbiotic relationship between buildings and nature, the happier and healthier humans will be. At the International Living Future Institute (ILFI), Amanda and her team focus on biophilic buildings: structures that utilize and celebrate biophilia (love of connecting with life and nature). She worries that the gap between humans and nature is growing too wide and believes that the relationship needs to be repaired to support healthier lives. By incorporating living elements into her designs, as well as infrastructure that more closely resembles what we would find in natural settings, Amanda strives to provide a way to design not just a building, but the relationship between people and nature.

Road traffic, sporting events, concerts, construction sites, airplanes. Sound or noise? Noise is defined as “unwanted sound”, not merely a volume, so it’s more a matter of perspective. However, the impact that noise has on our health is profoundly different than sound in general. Some consider noise as the next great public health crisis, and TEDMED Speaker Mathias Basner will tell us why. As an Associate Professor of Sleep and Chronobiology in Psychiatry at the University of Pennsylvania Perelman School of Medicine and the President of the International Commission of Biological Effects of Noise, he has spent much of his career exploring the effects of noise on our health, and particularly our sleep. With one of his studies focused on how traffic noise impacts sleep, his team broke down the difference of sleep disruption from road, rail, and air traffic noise. In order to support further research of the impact of disrupted sleep on psychomotor functioning, he worked on improving the validity of the tools used to measure impact. In addition to studying the relationship between noise and humans functioning on the ground, Mathias has also spent time studying sleep in space, and how to best prepare astronauts for a mission to Mars. He’s asking tough questions about how our circadian rhythm is impacted by prolonged microgravity and confinement. Mathias is pushing the boundaries of understanding how our biological rhythms interact with nature.

The CDC’s Most Unwanted List of threats is steadily growing with deadly superbugs that are resistant to antibiotics, making it more and more urgent that we develop new medicines to battle infectious bacterias. When many researchers continue to look for synthetic solutions to this natural phenomenon, Hive Innovator Sean Brady and his team at Lodo Therapeutics are digging in the dirt for answers. They seek new therapeutics to tackle drug-resistant microbial infections and cancers – some of humanity’s greatest dangers. To do so, the team at Lodo is using a gene sequencing technique to extract and sequence microbial DNA from soil. Recently, they discovered a cure for MRSA in rats, an antibiotic-resistant disease that also causes complications in humans ranging from skin infections and sepsis to pneumonia to bloodstream infections. Now working to improve the drug’s effectiveness in hopes of developing a treatment for humans, Sean and his team at Lodo are turning to nature for solutions to life-threatening problems.

Lodo’s Lab

What if our environment, and the devices that monitor us and our surroundings, could feed life-saving information to emergency response services? Michael Martin asked this question, and the answer is his work at RapidSOS. Using data collected by Internet of Things (IoT) devices and companies ranging from biometric sensors and cell phones to automobiles and home security systems, RapidSOS bolsters our nation’s outdated 9-1-1 platform with rich, dynamic information that can help first responders save lives. They’re building partnerships with a wide range of organizations to collect data from multiple sources and are already able to deliver a more exact location of people in need, speeding first responders to their aid. Their goal is to arm EMS with as much information as is possible and relevant to save lives and even contact emergency contacts to activate an extended support network. RapidSOS puts our digital environment to work to provide the best possible care in our times of crisis.

As we design more technology to manipulate our environment, it becomes clearer that we must not lose sight of incorporating natural elements as well. Whether it’s building biophilic buildings that integrate the synthetic with nature or measuring the impact of human-made noise on sleep deprivation and thus cognition, the relationship between what’s natural and synthetic has become more enmeshed, creating the hybrid world we live in. It’s using this hybrid environment for good, such as our personal data being fed to first responders, and digging in the dirt for antimicrobial organisms, that allows us to progress forward, hand in hand with nature instead of fighting it.

Building Beacons of Quality Care

There are endless, and occasionally insurmountable, hurdles that prevent people from receiving quality care. It may be the distance to the nearest hospital, or the lack of resources at said hospital, or that a “nearby” hospital simply doesn’t exist. This Speaker Spotlight will focus on the Speakers and Hive Innovators who are “bringing the mountain to Mohammed,” whether by building hospitals in communities that previously did not have them, or deconstructing the operating room and bringing it to a patient’s home. Each of these leaders has found ways to improve access to quality health care in communities that were often left behind.

Dikembe Mutombo has never lost connection with his home country, the Democratic Republic of Congo. After coming to America on an academic scholarship to study medicine at Georgetown University, Dikembe went on to an impressive eighteen-season career in the NBA. Throughout his career as a professional basketball player, and especially after retiring from the Houston Rockets in 2009, Dikembe has always been committed to using his celebrity status as a force for good. With a passion for improving the lives of the underserved—particularly those living in the Congo and throughout Africa—Dikembe has worked on projects and initiatives that help to ensure that those in need have access to health care and economic opportunities. In 1997, he established the Dikembe Mutombo Foundation, which strives to improve the health, education, and quality of life for the people in the Democratic Republic of the Congo. One major Foundation project was the construction of the Biamba Marie Mutombo Hospital in Kinshasa, Dikembe’s hometown, which has served 300,000 people in the area since opening in 2007. Dikembe lives out the belief that every person, no matter where they live, deserves access to quality care and has built a beacon to share that vision.

Dikembe being honored at Dana-Farber Cancer Institute, Brigham and Women’s Hospital (BWH) and Harvard Medical School’s Global Health Catalyst Summit

As we know, equitable access is not merely an issue of having a hospital nearby. The quality of care within a hospital is critical, and one would hope, equal. However, Elizabeth Howell’s research shows us that outcomes are not equitable in all cases. As the Director of The Blavatnik Family Women’s Health Research Institute, and the Mount Sinai Health System Vice Chair for Research, as well as a Professor in the Department of Obstetrics, Gynecology, and Reproductive Science, Elizabeth witnessed the disparity in outcomes that minority groups, especially Black women, faced in her field. In a study published in 2016, Elizabeth and her colleagues point out that “a significant portion of maternal morbidity and mortality is preventable making quality of care in hospitals a critical lever for improving outcomes.” With this fact in mind, they studied the differences in hospitals in which black and white women deliver. They found that black women are more likely to deliver at higher-risk hospitals, and called for further research to define the attributes that make hospitals high performing. It’s not enough to have a hospital nearby for a woman to deliver, so Elizabeth is leading research that will help ensure that hospitals provide all mothers high-quality care.

When it comes to improving health care for the underserved, Mitch Katz is all about achieving measurable results and lasting changes. As President and Chief Executive Officer of NYC Health + Hospitals, the nation’s largest public healthcare system, Mitch leads an integrated health care system of hospitals, neighborhood health centers, long-term care, nursing homes, and home care, which together function as the public safety net health care system of New York City. Although it’s a big job, Mitch has the right experience: his last few decades were spent directing the San Francisco Department of Health and then the Los Angeles County Department of Health Services. While in those two California cities, Mitch achieved many public health victories including funding needle exchange, the creation of an ambulatory care network, and the elimination of the department deficit through increased revenues and decreased administrative expenses. Having taken over NYC Health + Hospitals in early 2018, Mitch has already set ambitious goals for the system, including achieving fiscal stability and transforming the primarily emergency department-focused system into a primary care-focused system. Many people look at US cities’ health care systems as broken and a nightmare, but Mitch looks at them, sees their potential, and finds a way to turn the oil tanker.

There are around 5 billion people in the world who don’t have access to safe, clean surgical care. Debbie Teodorescu and the team at SurgiBox are looking to change that. Instead of requiring a sterile operating room for surgery—which is difficult in many developing countries where dust, bacteria, and flies are present when doctors are working in the field or can also contaminate operating rooms—SurgiBox is redesigning what safe surgery looks like. With their simple, inexpensive, and ultraportable inflatable surgical environment that fits in a backpack, Debbie and the team are making clean surgeries available anywhere. Instead of requiring a full room for surgery, SurgiBox is simply inflated into a clear bubble around the patient’s surgical site, sealed for sterility, and operated through via ports. Imagine the possibilities for quality health care access with a portable OR!

When faced with glacial sized challenges, it is clear that many members of the medical community roll up their sleeves and get to work, chipping away at the behemoth. While there are few like Mitch, who found a way to reshape massive health care systems to meet the needs of the patients while making the system more sustainable, we know there are many who are fighting the everyday Goliath’s in health care. While Mitch has shown how to make large-scale, systemic changes, there are pioneers like Debbie who are bringing safe surgery to places where it does not exist. Even when there is infrastructure in place, we are grateful for researchers like Elizabeth, who make sure that we know where to hold our systems accountable with the very real statistics facing underserved communities. Regardless of how they reinvent access to health care, each of these champions is forging a way to bring quality care to communities and patients that others overlooked or ignored.

Social Experiences at TEDMED, Powered by Our Partners

At TEDMED this year, join our Partners in uniquely designed experiences and conversations that highlight the powerful and impactful ways they are pushing boundaries and improving the health of individuals, communities, and nations around the world.

Each of our Partners embraces the role that Chaos+Clarity has in driving innovation, advancing science, and creating healthier communities, and we are excited that they share their cutting-edge ideas and devotion to a healthier world with the TEDMED Community. Below, learn more about their experiences at TEDMED this year – and register today to join them on-site at TEDMED 2018: Chaos+Clarity.

This year, The Robert Wood Johnson Foundation, through a collection of new, original stories about an emerging future Culture of Health, will feature the work of some of today’s most thought-provoking futurists and fiction authors. Five authors will join us and share how they imagine a healthier world. The TEDMED Community is invited to read each author’s story and engage with them directly in the RWJF Hive Lounge, and at a special Stories Under the Stars evening event. We’re excited to explore how fiction can help inspire a healthier future with RWJF and the TEDMED Community.

  Ensuring that all have the basics to be as healthy as possible.

AMA HealthBytes, a new game, will be launched at TEDMED this year. Are you up for the challenge? Put your knowledge to the test with “Mission Possible: Normal Blood Pressure” and “Practice Master”. Whether you’re a patient or physician, you’re bound to learn something new! After testing your knowledge with HealthBytes, join AMA leadership for Fireside Chats in the Hive about topics ranging from A.I.’s potential in healthcare to how digital tools can improve patient care and enable lifestyle change.

 Attacking the dysfunction in health care by removing obstacles and burdens that interfere with patient care—that’s the work of today’s American Medical Association.

We’re excited to have Joule, a Canadian Medical Association company, create different health care environments in the Hive, showcasing how virtual care tools can assist in improving access to health care. Experience an aging community on Wednesday, an at-risk community on Thursday, and, a remote community on Friday. Each day, you’ll learn about innovative initiatives and see practical, hands-on examples of physician-led innovation. Interact with cutting-edge innovations, and envision the potential impact these initiatives could have in your own local health care setting and how they can help solve current health care delivery challenges.

 Driving breakthroughs in health care innovation and system change.

Do YOU give a care? The SCAN Foundation is asking the TEDMED Community to add their voice to this important campaign that highlights the role Millennials play as caregivers while helping them create communities of support. They’ll also be hosting a live podcast recording hosted by their CEO, Dr. Bruce Chernof, about supporting younger caregivers to create community and find clarity. You can join the conversation on social media before you get to TEDMED, and share your personal story of providing care for an older relative or loved one, explaining why and how #YouGiveACare.

 Empowering Millennial caregivers across America with knowledge, resources, and supportive communities.

What really matters in health today? This question, along with the role you can play, is what Geisinger will explore with the TEDMED Community this year. Join Geisinger leadership, including President and CEO Dr. David Feinberg, as they tackle some of the biggest questions we face in health today: What is the responsibility of a health system to support the social determinants of health? What is the main barrier to bringing lifestyle medicine into routine clinical care? Can, and should, we have an opioid-free world?

 Providing clear vision on how to change health care nationally, from treatment to prevention.

What is the role that social, economic, and environmental factors play in our health and health outcomes? Join Humana at TEDMED to explore these questions and inspire solutions.

 Collaborating to untangle the complex web of social and environmental factors to design a comprehensive, integrated approach to improve health.

We’re thankful to have such amazing leaders joining us in our mission to help shape a healthier future. We hope you’ll join us and them at TEDMED 2018 to explore big issues and discover new solutions.

Community Change, From the Inside Out

Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.
—Margaret Mead

From infectious disease to opioid addiction to sexual violence, there’s a myriad of pressing health and social issues facing communities around the globe. Sometimes the global community steps in to help, providing aid where needed, but other times local communities are left to fend for themselves. Unfortunately, low-income and underserved communities not only have limited resources to tackle such issues on their own, but they also often find themselves facing an intricate web of many other deeply-rooted challenges. Despite the injustices of these situations, we often see people within these communities who take it upon themselves to inspire the change they want to see around them. At TEDMED 2018, we’ll feature 4 Speakers and 1 Hive Innovator who are employing innovative ideas and unwavering determination to address the complex challenges facing their communities. Through their work, these individuals are proving that the most sustainable and effective change often starts at the local level—from the inside out.

In Malawi, nearly 1 in 5 babies are born prematurely, and the southeast African country has faced significant challenges supporting these babies with basic functions such as breathing, feeding, and body temperature regulation. Refusing to be a bystander in the face of these heartbreaking statistics, pediatrician Queen Dube and the Queen Elizabeth Hospital have been working with Rice University in Texas, along with other international partners, to test and implement life-saving technologies through the NEST 360 program in order to avoid preventable deaths and save babies’ lives. These technologies are unique in that unlike most medical equipment, they are built to withstand the harsh environments in which many African hospitals operate. In an interview with the BBC, Queen describes one of the life-saving technologies, a bubble CPAP machine, which her hospital uses with premature babies who are struggling to breathe. Between these new technologies, government initiatives, and innovative partnerships, infant mortality rates are now on a steady decline in Malawi.

Infant receiving care at Queen Elizabeth’s Hospital

Sometimes a community is forced to face an onslaught of seemingly insurmountable challenges all at once—such as when it is confronted with a natural disaster. After Hurricane Maria, Puerto Rico found itself in this difficult position. With power outages that lasted over 8 months and an alarmingly high death toll that wasn’t updated until nearly 11 months after the initial tragedy, many Puerto Ricans reported feeling a lack of support in their efforts to rebuild after the storm. Fortunately, amidst the devastation, there were community members like Christine Nieves who rolled up their sleeves and got to work. A few weeks after the hurricane, Christine and other community members opened Proyecto de Apoyo Mutuo Mariana (Project for Mutual Aid Mariana), a “comedore social” (social kitchen) in La Loma that not only provides the community with rainwater collection and filtration for cooking, solar panels, and free Wi-Fi, but also serves up to 300 meals per day. As Christine put it, she saw “Hurricane Maria [as an] opportunity to see the power is in ourselves and not in America.” Following in the footsteps of Christine’s community-led approach, buildings across the island now display a new motto: “Puerto Rico se levanta” (Puerto Rico raises itself). Not only is Christine’s work helping to revive a struggling community, but it is also instilling a strong sense of community pride and inspiring more community-led recovery projects across the island.

While it’s no secret that the United States has an unfortunate history of exploiting its farmworkers, many might be surprised to learn that there are still American farms utilizing slavery practices today. Greg Asbed co-founded the Coalition for Immokalee Workers (CIW), a worker-based human rights organization, to help end the systemic abuses he was seeing in Florida’s tomato fields. In the years following, Greg helped to expand CIW’s standards into a broader framework called the Fair Food Program (FFP), a unique partnership between farmworkers, Florida tomato growers, and select retail buyers. With the help of Gerardo Reyes Chavez—who was a farmworker for most of his life and is now a key leader of the CIW and FFP—the organization has helped to liberate over 1,200 farmworkers from farms where they were being held against their will and forced to work. Additionally, the CIW has gotten major corporations such as McDonald’s and Whole Foods to sign “Fair Food Agreements,” in which the companies agree to only do business with tomato farms that provide workers with fair pay and labor, education, complaint management systems, health and safety agreements, and more. Greg and Gerardo’s Worker Driven Social Responsibility model is now being applied beyond the agricultural industry—as far away as in garment factories in Bangladesh. In addressing and improving the unfair food system, Greg and Gerardo are giving a voice to an underserved community and paving the way for large-scale social impact.

CIW-organized farmworkers’ protest

Affecting community change often demands addressing systemic challenges head-on. Toyin Ajayi co-founded Cityblock Health to tackle the barriers to good health facing people in underserved areas and to provide these populations with the personalized care that they require. Driven by the belief that truly serving a community means extending healthcare services beyond the doctor’s office, Cityblock Health works to become active and responsive members of the communities they serve—providing its member base of those who access Medicaid, who are dually eligible for Medicaid and Medicare, as well as people living in underserved city neighborhoods, with high-quality care where-needed and when-needed. The company’s tech-enabled model not only effectively meets the complex care and social needs of its members, but it’s also helping to shift care away from the reactive, hospital-based acute healthcare system and toward a system that is more focused on prevention and community support. By providing customized local health care, Cityblock Health is improving the health of its community, block by block.

When it comes to driving meaningful change, sometimes it takes someone on the inside to clearly identify the problem and to find the best path forward. From Queen’s work implementing life-saving new technologies in Malawi, to Christine’s inspiring community resilience efforts in the wake of Hurricane Maria, to Greg and Gerardo’s victories in improving working conditions for Florida’s tomato farmers, to Cityblock Health’s implementation of personalized and localized healthcare solutions for underserved neighborhoods, TEDMED 2018 will showcase individuals who are not accepting the status quo. These outstanding Speakers and Innovators are stepping up to the plate and solving health and social challenges from the inside out.

How Ethics and Morals Bring Clarity to a Chaotic World

The terms “ethics” and “morals” are often used interchangeably, but there are important differences between the two. Ethics require a group consensus of some form, whether formal or informal, whereas morals is for the individual to decide. Of course, one impacts the other, with a sort of chicken-and-egg effect, and both have an enormous impact on how we approach difficult subjects and navigate complex problems. TEDMED 2018 Speakers Adam Waytz, Rabiaa El Garani, Sherry Johnson, and Suchitra Krishnan-Sarin are each tackling moral and ethical dilemmas and sharing their wisdom from the Stage this November. Whether through research or lived experience, these Speakers will share stories of exploring, grappling with, and resolving health-related moral and ethical dilemmas on both individual and societal levels.

Adam Waytz, a psychologist and associate professor at Northwestern University’s Kellogg School of Management, is interested in uncovering what motivates a whistle-blower, or a person who decides to come forward to report someone else’s unethical behavior. Adam and his colleagues have conducted research to discover the psychological determinants of whistle-blowing in order to shed light on the factors that either encourage or discourage a potential whistle-blower to come forward. Their findings revealed that there are two basic moral values at odds when someone decides whether or not they will speak out about an offense: fairness and loyalty. People who prioritize fairness over loyalty tend to show a greater willingness to be a whistleblower, while those who prioritize loyalty show more hesitation to speak out. Through his work, Adam is lending new insight into how the guiding principles of ethics and morals can vary so much from person to person and contribute to drastically different decisions.

There are some issues around which morality and ethics are seemingly clear-cut. For instance, Sexual and Gender Based Violence (SGBV) is widely recognized as a serious crime and human rights violation. Unfortunately, SGBV is still a common occurrence in far too many places in the world. As an international investigator of SGBV and a member of the Justice Rapid Response-UN Women SGBV Justice Experts Roster, Rabiaa El Garani has traveled to places that are experiencing deep moral and ethical conflict surrounding SGBV—including Syria, Iraq, Lebanon, and the Central African Republic. In the JRR-UN Women documentary Evidence of Hope, a survivor who shared her traumatic experiences with Rabiaa underscored the importance of Rabiaa’s SGBV investigative work, saying “After I met [her] I realized that there are some people in the world that care about us.” Rabiaa’s work is bringing justice to survivors of SGBV, voicing their stories, and laying the groundwork for a new code of ethics in parts of the world where SGBV is often ignored or even accepted. 

While SGBV is considered a crime in every state across America, many people would be surprised to learn that child marriage is not. Sherry Johnson is a survivor of child marriage who was forced to marry her rapist at age 11, and by age 27, she was a mother of 9. Today, Sherry advocates for the fair treatment of children and fights for the abolishment of child marriage in the United States. After spending the past several years lobbying the Florida legislature on the issue of child marriage, Sherry recently achieved a major victory with the signing of SB 140 into law, which restricts marriage in the state to those who are at least 17 years old. However, the fight is far from over—almost all states still have some legal variation for children to marry.  

Another ethical debate that concerns America’s young people surrounds the practice of vaping, which is the inhaling and exhaling of aerosol (also referred to as vapor) through an e-cigarette or similar device. Vaping and e-cigarettes were initially considered to be a less harmful alternative to smoking tobacco cigarettes, however recent studies have shown their effects to be much more deleterious than originally thought. Furthermore, with advertising that appears to target youth, candy-like flavors like mango and fruit medley, and devices that pack an alarmingly high nicotine content, the vaping industry has become the subject of extensive ethical scrutiny in recent years. Suchitra Krishnan-Sarin is a biobehavioral scientist and a professor of psychiatry at the Yale University School of Medicine whose research focuses on the bio-behavioral understanding of vaping and substance use behaviors in young people. By digging deeper into teen vaping behavior, Suchitra is uncovering important information that can be used by policymakers as they look to regulate the e-cigarette industry in an effort to help keep children away from the highly addictive and harmful habit.

From health and wellbeing to human rights and policy, we look to ethics and morals to help bring clarity to our often chaotic world. Although the lines between right and wrong may seem clear to many, such as in the cases of child marriage, SGBV, and teen vaping, the fact is, these are not universal truths. Furthermore, given the individualized psychology behind how we establish our morals, we may never be able to see eye to eye on some things. We’re excited to continue exploring the complexities of ethics, morality, science, and behavior from the Stage this year and to gain a deeper understanding of these concepts from TEDMED 2018 Speakers Adam, Rabiaa, Sherry, and Suchitra. We hope to see you there!

The Creative Potential of Data

When you think of the word “data,” what’s the first thing that comes to mind? Maybe statistics, graphs, or evidence? How about creativity? Probably not. In fact, many people think of creativity and data as polar opposites. However, what if that wasn’t necessarily the case? Just think about it: analyzing data requires imagination, finding hidden patterns, and translating information into relatable and digestible stories. Today’s Speaker Spotlight focuses on three TEDMED 2018 Speakers who are approaching data creatively and translating their findings to yield new insights in their areas of expertise. Whether it’s hacking the human genome, revealing how data informs behavior, or creating art from MRIs, these Speakers are telling fascinating stories through data in unique and exciting ways.

Data privacy is a hot topic today, but discussions of the issue are rarely focused on the importance of protecting our genetic data. However, genealogy expert Yaniv Erlich and his team made a shocking discovery when they found a privacy loophole that enabled the re-identification of allegedly anonymous male research participants using just internet searches and their Y chromosome. Dubbed the “Genome Hacker” by Nature, Yaniv’s work has pushed the science community to think about genealogy privacy from different angles and to find new ways to utilize our genetic data to inspire positive scientific progress. Yaniv is also responsible for assembling the world’s largest crowdsourced family tree, which includes information from 13 million people, as well as developing the website, which has gathered the genotypes of over 100,000 individual donors. With this complex layering of data, Yaniv is paving a path toward establishing a digitized genetic connection between every human alive.

Yaniv Erlich- Whitehead Institute from PMWC Intl on Vimeo.

In today’s digital world, health data isn’t being used exclusively by doctors and scientists. There are apps, devices, and home tests that enable the anyone to collect, monitor, and track their personal health data. David Asch, a behavioral economist at the University of Pennsylvania, warns that we should not look to these “quantified self” datasets as primary drivers of health behavior change, but instead we should view them as promising facilitators. In a 2015 JAMA piece, Asch and his co-authors noted that while wearable health tracking devices “are increasing in popularity, little evidence suggests that they are bridging that gap” between simply “recording and reporting information about behaviors such as physical activity or sleep patterns” and actually “educat[ing] and motivat[ing] individuals toward better habits and better health.” By diving deeper into the realities of quantified self data outcomes, David is working to move past the hype and to communicate what is most effective in inspiring positive health changes.

Of course, gaining insight into our health often requires more intensive measures than self-tracking, and many people undergo diagnostic tests such as CT scans or MRIs to see what’s going on inside of their body. While many people find getting one of these tests to be an unsettling experience, artist Marilène Oliver finds beauty and opportunity in diagnostic scans. Inspired by Hans Moravec’s idea that the Digital Age could one day enable us to download our consciousness, Marilène took the concept one step further and asked, “what about our bodies?” Finding that this question couldn’t be answered solely in virtual sculptures or fully physical structures, Marilène now creates work that strives to bring digitized bodies to life. Marilène’s art not only spotlights new and explosive ways to interpret our medical data, but it also helps us to more deeply explore questions surrounding our health, wellbeing, and physical body.

Marilene Oliver. Portfolio of Selected Work 2003-2013 from Marilene Oliver on Vimeo.

Data collection and interpretation has become a dynamic and creative process. With the power of a search engine, a smartwatch, or a PET scan, we are now able to glean insights into health and medicine that were previously unimaginable. For Yaniv, David, and Marilène, data has been the fuel that helped them to establish important new connections and to reconsider how they think about health. By unleashing the creativity and possibility inherent in data, these three speakers are inspiring us to look at information in new ways and to answer the question: how will you think about data?