TEDMED 2010 – Day 2 – Thomas Goetz, Craig Venter, Alex Berenstein, and More

Wow. What a long but eventful day, full of family values lessons from Mehmet Oz, the genesis of synthetic life by Craig Venter, and a history and future of interventional radiology by Alex Berenstein. Oh, and of course what conference would be complete without a blood draw by CVS, some DNA sequencing by 23andMe, and the discovery that your Medgadget editor Gene Ostrovsky had a few fourth cousins in the audience (as discovered by last year’s 23andMe genetic test).
The morning kick off was a tour de force beat poetry performance by Sekou Andrews and Steve Connell. Their masterful duet stunned the audience through wit, timing, and metaphor. And by stunned, we mean that they floored the audience. We all know that we saw something special that day. Beat poetry fan or not, when the video of their performance goes up on TED.COM (all talks eventually will), it’s a must see.
Thomas Goetz, Executive Editor of Wired Magazine had the rough fortune of following the masterful Sekou and Steve, but treated us to a talk on information’s power to enable behavior change when it’s personalized, has relevance, highlights choices, and prompts action. These principles of information design are far too rare in the world of medicine and seeing an opportunity, Thomas had his design team to re-think the construction of the lab report. The results were an epiphany of sorts, and Quest Diagnostics, if you’re reading this, you need to pick up the phone and call Thomas, immediately… because frankly, today’s talk made it even more clear that your lab reports are laughably designed, and they’re not meant to help either patients or in reality, even doctors, best understand and explain the results. The reports Thomas’s team created used color to indicate normal vs. abnormal, provided simple insights into what a high or low value means, and provided choices and actions based on the results. Everything was laid out beautifully and one glance at the reports Wired created was enough to interpret and understand them with a refreshing sense of simplicity. Not only that, Thomas’ team spent less than $10,000 on the project. Diagnostics companies like Quest and LabCorp are billion dollar businesses who churn out results that have dramatic lives on patients. They produce reams of data, that with the power of solid information design, is waiting to come to life, all for just a tiny, tiny price tag. Get to it!
Mike Barber, head of GE’s Healthymagination initiative jumped on stage next to talk about some technological disruptions GE is cranking out in health care. He spoke about GE’s new handheld ultrasound the Vscan, championed by some as the beginning of the end of the stethoscope. We’ve covered Vscan extensively on Medgadget (and have even tried it out), so we’ll spare you the details. Equally exciting, however, was Mike description of GE’s new digital pathology technology. Unlike nearly all other areas of medical imaging, pathology is still stuck in the the analogue age. Tissues specimens are still captured on a slide and pathologists still look at them under microscopes and write up their respective reports. Why? Simply because it’s immensely difficult to do a good job of digitizing a slide at the throughput pathologists require. Tissue on a slide, even thought sliced thin and smashed flat, is completely three dimensional. In order to digitize images of slides properly, you really need to take shots at 5 different focal planes to get the whole thing. Couple that with the various magnifications you need to include as well as the mechanics of handling hundreds of fragile, glass slides quickly and efficiently and things become tricky. GE, after years of R&D, however, has a system to do just that. They’ve got a set of pilots running in various pathology laboratories. For the first time ever, a patient’s pathology images might sit next to their MRI scan in a patient’s electronic hospital record.
The highlight of the last couple of talks before the first break was Emlyn Koster, the president and CEO of the Liberty Science Center, who showed us his initiative to get kids interested in science and medicine by showing them live surgery, by yes, piping in a live cardiac bypass at TEDMED. We were able to ask the surgeon questions, see the beating heart on screen, and meet the OR staff. When asked if the audience was a distraction, the surgeon replied that the operating room is a social place and the majority of these procedures are relatively routine.
After an hour long coffee break where were shot interviews, toured booths, and ate some snacks, we jumped back into talks with John Mackey, CEO of Whole Foods. John is a bit of a controversial figure in the world of health care given his strong opinions against the health care reform bill, so we were all interested to what he had to say. Instead of addressing the health care system, however, John talked about the employee wellness initiatives that are happening right now at Whole Foods. They’ve got a tiered discount system for their employees where everyone, regardless of health, gets 20% all food. Healthier employees (quantified by lab tests, blood pressure, and more), get increasingly larger discounts and the “platinum” employees, the most healthy, get 33% off all food. These bold incentives, John says, have yielded incredible results. They’ve also implemented a “health immersion” vacation, which is complementary but optional for employees at Whole Foods who are at the highest risk for medical problems. They take these people on a retreat that focuses on living a healthier lifestyle and again, John claims that the results are spectacular. He says that Whole Foods is in the process of writing up their work and once they do, they’ll “shout it from the rooftops.” The health immersion program has also more than paid for itself by lowering Whole Food’s health care insurance costs.
Next, Ray Cronise gave his interesting take on loosing weight, emphasizing that when the human body is exposed to cold, metabolism increases, and more calories are naturally burned. Thus, exercise methods like swimming (in cool water) might be especially effective for weight loss given the loss of body heat that needs to be regenerated in order to maintain body temperature.
Neurologist Frances Jensen was soon up to talk about her work investigating how our brain changes through the course of our lives and what these physiology changes might mean for treatment paradigms. Her most interesting insight was around epilepsy treatment in children. Most drugs on the market to treat epilepsy do so by upping neural inhibition though directly or indirectly simulating GABA receptors, which serve to, in essence, shut off a neuron. However, in younger children, there is significantly less inhibitory activity in the brain overall and much more excitatory activity. It’s thus illogical to use drugs that try and ramp up an already diminished inhibitory system. A better approach is to calm down the excitatory system. In a great example of rational drug design, they’re working on a medication to do just that.
We then had a sunny lunch on the hotel grounds and came back for a few talks that were more or less focused on genetics. Juan Enriquez was the first to speak on the topic, and proposed that as a species, humans are still evolving, but we soon might be the first species that’s able to control the direction of our evolution. Granted, we’re still years away from manipulating our own genomes to the point where it would be commonplace enough to ‘evolve’ our entire species, but Juan argued that evidence suggests that we’ll get there, and we should start thinking about the moral and ethical codes we’ll need to guide this now.
Two more talks on genetics followed, one by George Church, who among other achievements, helped initiate the Human Genome Project and another by Craig Venter, the first scientist to string together a known bacterial DNA sequence from raw ingredients, put it into a bacterial cell, and have it work – ie, synthetic life. George spoke of the dramatically decreasing costs of sequencing a whole genome and reiterated that it’s still far too early to tell what advances will come out of the ability to sequence DNA efficiently and cheaply. Craig walked us through his project to create synthetic life and talked about some of the ways in which the technology might be used to produce vaccines more quickly. Currently, when a vaccine is needed against a new, say, flu virus, the process takes months, partially because health organization have to collect and distribute live seed viruses to serve as the starting point to make vaccines. The ability to synthesize genes, however, would allow these seed virus sequences to be created the minute the WHO knows what strain of flu to target.
After another coffee break, we heard from Peter Daszak, and animal virologist who’s investigating how we might prevent the spread of novel communicable diseases by finding them at their source, in animals. Nearly all new pathogens (such as HIV and SARS) are pinpointed as having made the jump from animals to man. And it turns out that the diversity in the different types of viruses that live in animal species is astonishing, and we, on the whole, know very little about it. If we’re able to both learn more about these animal pathogens and at the same time be on the lookout for new viruses that have made the jump to humans, we might be able to stop an outbreak at its source. Through the help of predictive modelling to show the regions of the world where an animal to human jump is most liekly to occur, Peter is working with teams of people to monitor for unusual viral activity in animals and their co-habituating humans. What’s one of Peter’s biggest concerns? The adorable, soft, and potentially virus-filled animals like the sugar glider that are imported in mass quantities from tropical areas every day… right into our homes.
Following Peter, Walt Mossberg from The Wall Street Journal gave a talk on his personal struggle with diabetes and the awful devices that accompany it. He pulled out his glucometer and rightfully pointed out that it seems like its from the 1980s. Given that it’s clear how incredibly expensive unmanaged diabetes is to our health care system, he asked the device community to make products that help patients stay on target in managing their glucose levels rather than hinder them. Even the most innovative glucometer out there, he says, is still only a usb stick.
Helping to close the night was Alex Berenstein, a pioneer in the world of interventional radiology. Alex gave us a whirlwind tour of the field including how it started, how catheter technologies have evolved, what we’re doing now, and what we’ll likely be doing tomorrow. Our favorite part, besides the fact that Alex is a true innovator who helped develop a good portion of the technologies and techniques he talked about, was that he didn’t shy away from showing the audience some pretty gnarly medical images. Let’s just put it this way – it drew lots of gasps.
After the talks, we had a clambake on the beach, some good conversation, and we retired to our rooms to, well, write this.