September 12, 2014

TEDMED Day 1: Uncertainty, Amazingness, and Upside-Down-ness

TEDMED curator Jay Walker interviews NIH Director Francis Collins (L).
TEDMED D.C. kicked off wordlessly on Wednesday with skilled acrobatics by a pair from the Art of Motion Dance Theater hailing from New York, followed by a soulful performance by Jordanian singer Farah Siraj, who led us on an international musical journey with her talented back-up band.

Session 1: "Turn it Upside Down." This session had us re-thinking what we currently know (or thought we knew) about current medical dogma and approaches to healthcare.

The session opened with science journalist Sonia Shah challenging us to re-think our current paradigms of disease origin and treatment. Did you know that opossums can destroy up to 6,000 ticks per week simply through grooming? Yet our desire to rid of these pests may be hindering our ability to control Lyme disease. This was just one of many examples given. Next up, Eleanor Bimla-Schwarz from U.C. Davis discussed a hidden risk for heart disease: not breastfeeding your child in the weeks and months after giving birth. Sure, doctors can prescribe the usual regimen to prevent or treat heart disease: clean up your diet and exercise more. But without this key preventative, Bimla-Schwarz says that there are an additional 14,000 heart attacks, 54,000 medications prescribed, and billions of dollars spent needlessly every year. Actor and playwright Heather Raffo took to the stage next as "Somora," a 9-year-old Iraqi girl detailing her feelings of oppression during war and misunderstandings with her family. Doctor Danielle Ofri from Bellevue Hospital spoke next, revealing a medical error that she kept secret for 25 years: she missed an intracranial bleed in a patient (that, luckily, a resident caught). The current culture has a zero-tolerance policy when it comes to medical error, but Ofri argues that we should speak openly about and accept these errors as part of human nature. Finally, Ted Kaptchuk of Harvard and director of the Program in Placebo Studies described noticing, strangely, how patients' mobility seemed to return once he wrote them a prescription. In a series of experiments, he detailed how placebos can, in some cases, be just as effective as a drug for subjective alleviation of symptoms.

Session 2: "We Just Don't Know." After connecting with our friends in San Francisco for the first time (hi, sleepyheads!), TEDMED curator Jay Walker opened the session by asserting that "healthcare is going to change more in 20 years than is did in the past 20,000 years." It's time to "re-imagine what it means to see disease and how we respond," and perhaps the best way to do that is through "science-based imagination."

The session opened with Elizabeth "Betsy" Nabel, giving us the comforting thought that "none of us in science and medicine have the answers we tell you we have." Her message was simple: it's dangerous to be too sure in what we think we know, because there's "nothing wrong with being wrong." Next up, streaming live from San Francisco, I was excited to see neuroscientist Jeff Iliff, part of the research team at University of Rochester that examined how during sleep (but not wake) cerebrospinal fluid rushes between neurons to clear waste. Sixteen-year-old Rosie King took the stage next, describing the thousands of worlds that run through her head, more real to her than the "real world." Self-diagnosed with autism when she was 9, she says she wouldn't trade her autism and imagination "for anything in the world." (She received the first standing ovation!) Next up, Daniel Webster, Johns Hopkins professor and expert on gun violence prevention, proposed three gun ownership laws that don't require a ban or a breach of the 2nd Amendment: prohibition of ownership if one has previous drug, weapon, or domestic violence offenses (but the ban doesn't have to be lifelong); stronger penalties for underground gun dealers; and identification information on bullets to know who, exactly, purchased the gun that fired the bullet. Finally comedian Tig Notaro described the worst four months of her life where she not only contracted C. diff and experienced the sudden death of her mother, but also went through a break-up and, finally, a cancer diagnosis. Her message was simple: whether you have a deadly disease or not, nobody knows their end date. Don't waste time when it comes to finding healthfulness and happiness.

Session 3: "Flat Out Amazing." The title says it all. These speakers were creative, innovative, and stretched beyond what they thought they could do to achieve some flat-out amazing things.

Diana Nyad speaks candidly about her 53-hour, 110-mile swim last year.
Gail Reed founded Medical Education Cooperation with Cuba (MEDICC), a U.S. nonprofit that improves health and communication from Cuba to other global health communities, which was inspired after two hurricanes whipped through Cuba and left entire communities without healthcare. Scholarships are available for students, and MEDICC now has over 23,000 graduates from 23 nations. Next, we were transferred over to San Fransisco to hear from Elizabeth Holmes, who opened by saying that "we can't engage individuals in changing [health] outcomes unless these outcomes are accessible." Holmes founded Theranos at age 19 which, among other things, requires only a microsample of blood to run a large battery of tests so the patient can get information quickly and painlessly. Back in D.C., TEDMED curator Jay Walker brought out NIH Director Francis Collins who spoke about personalized medicine, quantified health, and sequencing technologies. He encouraged scientists to speak beyond their ivory tower, for "we should not rest if [the United States is] going slower than [we] should be." Open water swimmer Diana Nyad took the stage next, detailing her hallucinations and thought process during her 110-mile open-water swim from Cuba to Key West: "If you want to reach that other shore, you'll find a way." She spoke about a 1 Million Walk Across America kicking off soon to encourage walking for health as a daily activity (and received the second standing ovation of the day!). Next up, National Geographic photographer Kitra Cahana in San Fransisco gave a moving talk on her father's locked-in syndrome, a result of a brainstem stroke that paralyzed everything from the eyes down, meaning that he couldn't even breathe on his own. She communicated with her father, a rabbi, by reciting the alphabet and waiting for his blinks as cues; fascinatingly, he found peace in his condition, declaring that "paradise is in this world." Finally, Marc Koska was inspired by a 1984 newspaper article predicting the spread of AIDS through the use of shared syringes. He showed the audience a horrifying undercover video of a nurse using the same syringe in an African clinic (including on a man with HIV and syphilis, followed by an infant). Koska developed a single-use syringe called LifeSaver that breaks when one tries to re-use it.

Day 1 ended with dinner and celebration at the Library of Congress, followed by me passing out on my friend's couch from sheer exhaustion and amazingness overload.

Stay tuned for Day 2 details coming soon, and feel free to tweet or e-mail me if you're interested in more details about any of these speakers. I have lots of crazy notes scribbled down!

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