We’re here at TEDMED 2011 and have just finished up day three of the conference. It was a spectacular. Yesterday (day 2) was solid and today (day 3) was stellar. The talks, ranging from mushrooms to the FDA, allowed TEDMED to really flex its muscles as a world class affair.
Today’s proceedings started with another song-based wrap-up (of yesterday’s talks) by Jonathan Mann and led into a talk by renowned photographer Rick Smolan. His photography book The Power to Heal was given as a part of the TEDMED schwag bag and his talk told the story of his career including the conception of the day in the life series which grew to be one of the most popular photography projects in history. His next goal is to produce a work that takes the digital pulse of the nation through “Big Data.” He’s on the hunt for collaborators so if you’re interested in how data reflects the state of human beings, email us and we can pass your thoughts his way.
After Rick, mushroom biologist Paul Stamets gave a stunning talk on how mushrooms (non-psychedelic) have the potential to be medically therapeutic. Given the unique place in the biological ecosystem that mushrooms live, they’ve evolved all sorts of properties that they use to interact with the world around them. On stage with Paul was an Agarikon mushroom the size of a pumpkin, one of the most rare mushrooms out there but also known to have potent antimicrobial properties. The mushroom lives for hundreds of years in very harsh conditions and it is thought that these conditions caused it to evolve these traits. Paul also spoke of a mushroom called the Turkey Tail mushroom that seems to raise base immunity function. He and his team got an NIH grant to study this mushroom in context of a compliment breast cancer therapy and found that it had extremely positive effects on the immune system of patients.
Most amazing however, was a mushroom called Cordyceps. Paul and his team were experimenting with the Cordyceps and they noticed that a specific extract from the mushroom had strange and rather remarkable insect attractant properties. Likely due to an evolutionary quirk, insects, including flies, mosquitos, termites, and more were remarkably attracted to the extract, to the point where spreading some would almost instantly draw insects in the thousands. Mosquitos, for instance, were nearly as attracted to this substance as a warm human hand. Besides building the most spectacular bug trap in existence, Paul plans to use his findings to attack zoonotic diseases.
After Paul, Gabor Forgacs from Organovo gave an update on his tissue printing technology. His company is essentially printing rows of cells just like an inkjet prints lines of ink, but by layering these rows on top of each other, they’re able to print fully three dimensional tissues. Right now they are using printed tissues as clinical trial models in order to enable pharmaceutical companies to make a better guess if their compounds will successfully pass human trials after being proven in animals. But they are also working on more directly therapeutic uses for their technology.
Currently they’re commercializing vascular tissue for scientific research but will likely soon do the same for actual implantation to replace veins or arteries. Longer term they’d like to print “organs” that may or may not look anything like our natural organs but would be functionally the same. Imagine a liver, for example, that looked like a rectangular block of tissue but had the same biochemical function as an actual liver.
Yoav Medan, Vice President and Chief Systems Architect at InSightec, gave the next talk about the advances he and his colleagues have made in non-invasive ultrasound surgery. In what was previously a dream but now made into reality, Yoav has figured out a way to pair fMRI and focused ultrasound beams to heat up and destroy focused areas of tissue inside the body without a single incision. He showed us a little piece of gel that had a small hole cut out of the middle through focused ultrasound. It is an amazing thing to be able to instantly ablate a precise region of human tissue without ever making a cut and he’s first targeting brain surgery. By locking down the patients head in the MRI machine, they’re able to make precise lesions in the brain that would have previously required extensive and dangerous surgery.
Up next was Alexander Tsiaras from the Visual MD. His company is bringing visuals to the complicated world of medicine to help people better understand what is going on inside their bodies through videos, infographics, illustrations and images. We’ve previously covered Alexander’s company and at this TEDMED, he gave an update on their latest product plans. One of their latest goals is to help people better interpret their lab results by showing in rich detail exactly what each test means on the level of the body’s physiology and how the results relate to overall health. They’ve built partnerships with diagnostic companies and are hoping to grow the Visual MD into a go-to portal for patients to interpret what’s happening inside their bodies in the utmost of visual detail.
After a lunch on the Hotel Del Coronado lawn, the18th surgeon general of the US, Regina Benjamin gave a wonderful talk about the changes in the health agenda at the government level. Her and her team, in concert with HHS are pushing a National Prevention Strategy, refocusing their efforts on reducing the incidence of disease rather than treating it once it has already arrived. After listening to Regina, we really got the feeling that the government and health care system as a whole is not just talking about prevention but actually taking a serious stance in trying to get it done. Kudos to her and her team.
Along the same lines, David Kirchoff, the CEO of Weight Watchers, spoke about how the last two years have really signified the medical renaissance for his firm as the world starts to pay more attention to obesity as an epidemic that has the potential to bankrupt our health care system. He showed a lot of petrifying charts about how obesity has increased throughout the nation at a dramatic rate. Even Colorado, having a stereotype of being the healthiest stage in the nation would have been the most overweight in 1990. Obesity related illness such as diabetes are already at epidemic levels and are threatening to get much worse. He thinks that a confluence of behavioral factors helps Weight Watchers to be successful and feels that his firm along with others in the face are poised to make even more of a difference in the years ahead. It is notable that he opened his talk with the question “Is obesity a solvable problem?”.
Dan Buettner, world record holding endurance cyclist and documentarian, was up next to talk again about his experience, funded by National Geographic, of seeking communities across the world that were previously unhealthy but became healthy. Dan noted that our current approach of dieting to losing weight and combating lifestyle disease is severely flawed. It doesn’t matter what the diet is, if you take 100 people and put them on it, almost none will still be following it after 7-8 months. His idea after his journey with National Geographic was to build and deploy community transformation programs that don’t simply ask people to change their habits but rather sculpt the environment around them to enable it. Sponsored by AARP, he and his team ran a pilot community transformation program in Alber Lea, Minnesota where they expanded parks and paths, worked with local restaurants to change their food options, and engaged with the social networks of the community itself. His results were staggering. They were able to get 60% of the city’s local restaurants involved, 100% of its schools, and 27% of its citizens. They also saw a 49% drop in city worker’s health care costs. He’s looking to scale this model more broadly, possibly to the whole state of Iowa next year.
After Dan, Mehmood Khan, the Chief Scientific Officer of Pepsi spoke about the necessity of processing food and how new technologies for processing can help feed the world more healthily. Mehmood argues that there are simply too many people in the world to feed without processing food so rather than apply a label of negativity to the word processed, we should re-think how it is done and innovate ways to make food last longer, contain more nutrients, and get to people who need it. He said that we’re wasting an incredible amount of food in the world because of simple spoiling, and he and his team at Pepsi are not only re-thinking their entire food strategy to focus on healthier options but are innovating new methods of getting better food to more people.
In a hilarious and aptly timed demonstration, Gabor Forgacs from Organovo got on stage next to talk about printing meat with his tissue printers. He had talked previously about using them to regenerate tissue for human health, but it is equally possible to take muscle cells and print them for human consumption. He brought up a little frying pan, opened up a vial, and pulled out a strip of “printed” pork that he made using his technology, heated it, and ate it right in front of us. The whole spectacle was hilarious and the audience was loving every moment. He’s not sure what to call his new type of meat but is leaning toward “lab meat” or “in vitro meat.”
Lunch was up next and thankfully they didn’t have Gabor plan the menu.
After lunch we had an update from author AJ Jacobs on his year of living as healthily as possible followed by a great talk by Dean Kamen. Instead of focusing on updates from his initiatives, he gave an illuminating rant on the FDA. He had trouble getting his non-invasive, DARPA-funded, prosthetic robotic arm through as a class one device. In a comical chain of events, immediately after receiving this news he was asked to be the keynote speaker at a conference in DC where the head of the FDA would be on stage with him. He decided to use this opportunity to present his 510(k) class II application for his prosthetic arm. In it, he had to identify a predicate device that has already been approved which would be reasonably considered to be equally or more safe than his arm. Dean chose a chainsaw. After this rant Dean reminded the audience that we as a society chose to have a system that doesn’t tolerate risk in medicine and though it is all too easy to simply point fingers at the FDA, we’ve got to actively move past this and chose a new system through our votes and voices.
After Dean, biomedical engineer Chris Toumazou gave a fascinating talk on (among other topics) how as electronics increasingly interface with biology, we should shift to from digital circuits to analog. The digital world of 1s and 0s simply doesn’t match up to the way the body processes data, interprets electrical inputs and crafts outputs. Chris thinks that this sort of shift is already here, and it will continue to produce remarkable advances in implants and devices. For instance, he and his team have used this sort of electrical engineering to build incredibly low power and inexpensive cardiac monitoring patches as well as a new and faster DNA chip built for detecting specific mutations.
Up next was Robert Hariri, CEO of Cellular Therapeutics, who just like at FutureMed, blew us away with the work he and his team are doing on stem cells. His company is using placenta-derived stem cells as a platform for therapy and is already co-axing these cells into doing remarkable things. An early application of his work is in Crohn’s disease, a poorly understood immunological inflammatory GI condition. He showed us before and after endoscopies of Crohn’s patients and the results were startling – almost a compete remission of the disease. His company is also de-cellularizing organs and once again using their placental-derived stem cell technologies to repopulate the left over non-cellular structures (think scaffolding) with new tissue. Lastly, Celgene is using the structural framework of placentas to create sheet collagen that can be used in wound repair. They’re creating patches that are currently being tested in burns and the results are stunning. The patches allow the patient’s own skin cells to populate the collagen scaffolding which dramatically improves healing and reduces pain.
After learning about stem cell use from Robert, we transitioned into a talk by Charles Limb, musician and cochlear implantation surgeon who noted that even though we’ve as a society have been remarkably successful in improving hearing disorders through implant technology followed by speech therapy, patients with cochlear implants still can’t interpret music as beautiful. Charles is an avid musician himself and wonders if we could help train children with implants for music recognition in the same way we do for speech… at least until better technology arrives.
Keeping with the music theme, beat boxer and MIT graduate Nate Ball took the stage and not only demonstrated his incredible talent first hand but endured a live laryngoscopy, on stage, to demonstrate how his throat anatomy created such interesting sounds. His robot voice, for instance, which he thought was simply his vocal cords turned out to be created by his arytenoid cartilages vibrating against each other. He is also able to make his lips and tongue vibrate musically as well and when he puts all of these talents together, has a veritable drum and synthesizer kit all above the neck.
Chuck Pell was up next to talk about his biomechanist approach to creating medical inventions. His latest passion is to modernize surgical tools through tissue science, starting with the retractor, a technology he says has not changed for hundreds of years. His company Physcient is building an electric retractor that for their first procedure, a thoracotomy, might have great patient benefit. Thoracotomies are notoriously painful procedures, largely due to the force applied to opening the surgical space, ripe with nerves. He has created a simple electric device that distributes the force properly over time and space. In his animal models, this has decreased post surgical pain dramatically.
After Chuck, Jay Walker closed out the evening with a preview of how TEDMED is changing under his ownership. In summary, Jay his big ambitions for the conference to make a large impact in the world of medicine and he feels the best way to make change is to bring the conference to DC. The next TEDMED will be this coming April at the JFK Center for the Performing Arts in Washington, DC. His vision is to sit in our government’s back door and use this proximity to influence the course of medicine and improve the health of the nation and the world. The conference will be bigger, will be streamed live and for free throughout DC, and will be structured on a different attendance model, in which core attendees will be on the floor of the JFK center during the talks and will represent various disciplines as delegates. The other attendees will be in the balconies. From what it seems at this stage, if elected delegates cannot afford the conference, they will be given a scholarship and attendees in the balconies will be able to come for free.
It is very clear that the feel and goal of TEDMED is changing and this was a hotly discussed decision at the conference. But after hearing Jay’s call to bring the audience’s collective voice to Washington to maximize the impact on health care, it felt like the audience was absolutely on board and willing to give it a try. The next conference this April will be a fascinating change.
Wow, what a fantastic day of talks from some of the most interesting people in medicine! We’ll see you tomorrow.
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