Day three was packed, with over twenty talks between 8am – 7:30pm, ranging from Frank Gehry talking about his memory in his old age to Danny Hillis describing his views on a shifting paradigm in cancer treatment, away from genes and towards proteins.
In traditional TEDMED fashion, the day started with entertainment. Jill Sobule, TED & TEDMED veteran musician, sang a song from the perspective of a 100 year old woman and Jay Walker, founder of Priceline.com, gave us a tour of some historical medical books from his personal collection. After that, Richard and Marc (the conference organizers) brought on Frank Gehry, Moshe Safdie, and Quincy Jones to more or less talk about being old. Richard cautioned he didn’t know how this session would go and the reality was that bringing them on was an excuse to have a good, fun chat with some good friends. And something about hearing Quincy and Frank discuss their memory loss and annual checkups was fantastic. Besides the revelation that Quincy has a seven day long physical every year in Sweden, nothing much was *really* said on stage but it was mesmerizing watching those four legends (Richard included), all over 70, joke and laugh about their medical conditions. Opportunities to be a part of such casual conversations with people like Gehry and Jones don’t come around often.
Sherwin Nuland, author and professor of surgery at Yale got on stage to speak of the need to rethink the medical curriculum. He described the evolution of medical education from a hap-hazard unstandardized state to one that resembles what we’ve got today. The changes that brought sophistication to medical education required canalization by disruptive people and leaders. Sherwin emphasized that the world of medical education today needs another great transformation and that current curricula are not well suited for the current state of affairs. His proposed solution is the undertaking of a massive project by the Institute of Medicine to re-think the way doctors are trained.
Up next was venture capitalist Henry McCance, who spoke about the need to rethink the model of funding in academic research. Too many researchers, he argued, spend too much time writing for grants and end up waiting too long before decisions are made. Not only that, but the grants themselves have become risk averse and conservative. He proposed a model of academic funding similar to venture capital, where riskier research initiatives are funded and ideas that might trigger breakthroughs rather than incremental improvements are embraced rather than rejected. This idea hit home when Rudolph Tanzi, Alzheimer’s researcher came up next to describe how private funding arrangements allowed his lab to discover a whole set of new genes that are related to Alzheimer’s.
After a break filled with snacks, coffee, and interviews (keep checking Medgadget – we’ve got some great ones for you), we heard from Danny Hillis, co-founder of Applied Minds, give a talk on his vision of cancer treatment in the future. We had not heard of Danny Hillis before yesterday but he’s got a remarkable background. He pioneered the concept of parallel computers, has hundreds of patents, and is even a former vice president at Disney Imagineering. When he stepped on stage he mentioned he was nervous because, paraphrased, “there’s a lot of people in the audience that know a whole lot more about cancer than me. And what I’m about to show is outside the normal paradigm of cancer treatment.” He started with a thought experiment, asking if you could determine if a restaurant had good food by simply looking at its ingredients. Sure, he said, you’d be able to tell the difference between a Chinese restaurant and a French restaurant, and you could make a guess that since one restaurant had more margarine than the other, one might be healthier, but really what you’d want to see is the quality of the dishes themselves. The dishes in a restaurant, he said, are analogous to proteins, and the ingredients parallel genes. Given that proteins do the real work in the cell, it would be more fruitful to look at what proteins are being expressed in tumors vs. non-tumors. The only problem with this approach is that getting the proteome of a cell is (was) extremely time consuming and unreliable. It was a long, human-dependent process, and one which Danny had tried and failed to improve twice. The third time, motivated by oncologist David Agus, he figured it out and developed a system to automate getting a complete map of the proteins expressed in a cell. He showed us some output images from the system and it has remarkable precision, up to the point where it could distinguish proteins containing different carbon isotopes. He argued that soon we’ll be looking at these maps to treat cancer and using them to find trends and develop treatment protocols. Powerful stuff.
Next up on stage were aging and life extension scientist Aubrey deGrey and regenerative medicine researcher Anthony Atala. Aubrey is a quirky figure in the world of science, with a long beard and provocative views on aging and immortality. Anthony Atala is, by impression, much more grounded and lives in the world of tissue engineering. The most notable thing about their joint talk was not what they said but rather that their institutions, the SENS Foundation and Wake Forest University, are going to partner together on some projects. They approach the idea of fixing the human body from highly different angles and it will be interesting to see the results from their collaboration.
After a sunny lunch outside filled with interviews, we wandered back into the conference room to hear from Hugh Herr, an incredibly talented rock climber, who, while attempting to summit Mount Washington, ended up getting severe frostbite and needed both legs amputated. He treated his predicament as an opportunity and has spent his life at MIT developing cutting edge prostheses. He talked a bit about how the devices are becoming so advanced that they interface seamlessly with the body and gave us a tour of his own pair of legs. Each of them has their own computers and were powered by complex robotics. At the end of the talk he showed us what is possible with this new class of devices by rapidly jumping up and down, and quick jogging on stage.
Fittingly, Dean Kamen, creator of the world’s most advanced prosthetic arm, was up next and spent a bit of time giving updates on his arm technology (the new version is slick!) and the rest split between his unique water filter and his initiative with FIRST robotics. Years ago Dean created an amazing water filter that’s able to transform literally any quality water into pure, healthy, drinking water. He described the progress they’ve made in getting it smaller, cheaper, and more reliable and yet, still, they’ve had tremendous difficulty getting the filter distributed for use throughout the world. Since the filter is not yet produced at high volume, though they’ve made efforts to reduce the cost, it’s still expensive, and more critically, hard to distribute to thousands of remote locations all across the world. Ironically, after years of hunting for a partner to help out with this, in exchange for some fluidics innovation to develop auto-mixing multi-flavor soft drink vending machines, Coca Cola is going to help him out! Pilot programs are starting and hopefully this thing is poised to take off. Lastly, Dean talked about his initiative with FIRST, a robotics competition for high school students, and how he, with the help of a donation from Google, is going to have the competitors raise money for the competition by selling new energy efficient light bulbs from LED leader CREE – think girl scout cookies but for future engineering superstars.
Right after Kamen, in a remarkable unveiling of new technology, Stephen Oesterle of Medtronic showed off the next generation of pacemakers that are planned to be available in about three years. The device is about the size of a Tylenol Extra Strength capsule, is catheter delivered into the heart, and has retractable grippers that attach the pacer directly to the inside wall of the organ. Because of this there are no leads and hence no lead related problems. The pacemaker will allow for wireless monitoring and maybe even programming via devices like smart phones and is expected to not need battery changes for up to a decade. Because of its small size, it should be relatively easy to swap it out for the next version ten years later, which we imagine will probably be invisible.
Oesterle talked about the two dozen, or so, areas where electrical pacing is currently done on the body, helping treat everything from obsessive-compulsive disorder, to cardiac conditions, Parkinson’s, and chronic pain. The expected miniaturization of implantable pacing systems should allow for an even greater variety of applications, since, as Oesterle mentioned, pretty much everything in the body is regulated via some kind of chemo-electrical signaling.
Then, after another break, the last session of talks for the day started. Craig Fugate, the current director of FEMA, was particularly inspiring. Given the incompetence of the former FEMA administration over Katrina, hearing Craig talk was refreshing. He was articulate, practical, and oozed experience and insight. The thesis of his talk was that FEMA needs to leverage the population and the private sector as partners to help in disaster recovery and not think of them as a liability. For instance, instead of sending out FEMA employees to the site of the disaster only to report back what could have been discovered by looking at YouTube videos and reading Twitter, they’ll, gasp, watch YouTube videos and read Twitter because it will enable more rapid and accurate response. He then took things a step further and prompted us all to think about what it would take for local populations to become more “immune” to disaster in the traditional sense. Maybe they could deploy infrastructure and protocols at the scale in which, if disaster did strike, communities at all levels would be more ready to respond, right away.
Soon after Craig, Marc Koska spoke about his passion to create and deploy a syringe that, once used cannot be used again. After you inject the medication using this syringe, it locks in place, and if you pull the piston out again, it just pops off. Given that millions of unsafe injections occur each year around the world, this technology has a tremendous potential to prevent the spread of disease. He profiled a sadly, non-extraordinary treatment center in India that was injecting an entire patient floor’s medication with two syringes. After some extensive prodding, the government in India agreed to make his technology standard for all government hospitals and clinics. His syringe is credited with saving over nine million lives.
With the day coming to a close, David Blaine got on stage and promised he’d show the audience how to do some magic tricks. He proceeded to take a bite out of a wine glass and chew it up. He then stabbed a needle all the way through his hand. Lastly, he swallowed a surgical suture and pulled it out through his stomach skin through the right of his belly button. Did David live up to his promise of telling how the tricks were done? No, he was messing with us. But we’re pretty sure he really did eat that glass.
One more day. Stay tuned…