Though TEDMED Day 3 started a little ominously due to an apparent fire at the Kennedy Center for the Performing Arts, we’re happy to say that it turned out to be as enjoyable and enlightening as the days before. The first session (and sixth so far) began with singer and songwriter Jonathan Mann, who regaled the audience with a TEDMED-exclusive song about the 51 Challenges, of which the top 20 would become this year’s official TEDMED Challenges. Later in the day the top 20 were announced and the highest voted challenge was inventing effective wellness programs, and you can see the complete list here: challenges.tedmed.com.
Following Mann was Caltech Professor Frances Arnold who spoke about her work making molecules “have sex” – that is recombining in order to create unique properties that may be medically relevant.
The next speaker, also a professor from Califonia (UC-Davis), was Jonathan Eisen, one of the foremost researchers on the human microbiome. After an experience hiking in West Virginia, Eisen was diagnosed with diabetic ketoacidosis and he believes it was because of something triggered in his gut flora. We know now that procedures that affect the health or development of our extensive microbiome, such as antibiotic overuse or Cesarean sections, can lead to diseases like C. dificil associated diarrhea. We also know that the gut microbiome is incredibly important to the absorption and even production of certain minerals and nutrients (e.g. Vitamin B12). Eisen discussed the emerging therapeutic use of fecal transplants for humans and stressed that it is time that “we view our microbiome as a functioning organ in our body” because there is evidence that it may affect many other physiological processes besides digestion.
Next up was the living biology legend and professor emeritus at Harvard University, E.O. Wilson. He received two standing ovations for his words from a piece he called “Letters to a Young Scientist.” In it he articulates five key principles that will be known as Wilson’s Principles and were summarized as follows by Medgadget’s partner site, The Atlantic:
1. Breadth is as important as depth. Study widely.
2. March away from the guns.
3. There’s an ideal organism to study for every interesting problem.
4. Step away from the blackboard.
5. If you need math, help will come.
The session concluded with Penn State Professor Andrew Read who trumpeted the first of a number of urgent “calls to action” in today’s sessions; one theme between many of the day’s talks was the explicit call to the TEDMED delegates to spread the message of change. Read spoke about the need for antibiotic stewardship and, more generally, evolutionary management. Talking to physicians about changing their antibiotic prescription habits, he said, was like talking to patients about changing their diet and exercise habits: both know it’s important and will be good for society but many are unable to make the commitment. He urged the audience, filled with medical professionals and system administrators, to reconsider their ways so we could escape this drug-drug resistance arms race we are currently engaged in.
The next session focused on emerging robotic technologies and began with a talk by urologist Dr. Hiep Nguyen. There was one catch however: Dr. Nguyen was not at TEDMED, but rather in an office in Germany. He came in on a VGo tele-robotic system that he has used for patient consults; at one point, like many of his TEDMED counterparts, he actually paced (or rolled) around the stage while speaking!
Next up was fighter pilot and director of MIT’s Humans and Automation Laboratory Mary ‘Missy’ Cummings, who began by detailing her experiences flying jets for the Navy and her early realization that computers and robotic systems would always be more accurate in skills-based tasks like landing or aiming. Since then her mission has been to develop and apply these systems, whether unmanned aerial vehicles or surgical robots, to free up their human operators so they may focus more on intellectual tasks like problem-solving rather than skill-based tasks like dexterity, thus reducing the potential for error and complication. She was optimistic that tech-savvy and younger medical professionals would be open to adopting these systems, and compared the desire for change and potential backlash to her experience as one of the first female fighter pilots in the Navy: back then older male pilots were intimidated by the fact that she, as a woman, was doing what they were doing, and now they are joined by some healthcare professionals in being intimidated by the machines that she works on which are capable of doing what they are doing. These sentiments about gender and society were echoed in a later session today that featured award-winning journalist and cancer research advocate, Katie Couric, and sports icon and female pioneer, Billie Jean King.
Following Professor Cummings was designer Ed Gavagan who gave a heart-wrenching talk about being attacked and stabbed multiple times in New York. One of the stabs pierced his inferior vena cava – an injury that usually kills 95-99 out of every 100 people who endure it. If not for his excellent surgeons and the entire care team he would not have been able to speak with us, so he came to inspire from the perspective of a grateful and insightful patient. After a brief and beautiful musical interlude by violinist and neurobiologist Robert Gupta, MD/PhD, student Sandeep Kishore took the stage for another call to action: this time about mobilizing young professionals to care about chronic disease. The session wrapped up with a reappearance by US CTO Todd Park who spoke about what his office and the Department of Health & Human Services has done to attract bright entrepreneurial minds to solve healthcare and governmental problems.
Almost into double digits, the eighth session began with another heartfelt and elegant speech, this time by Red Cross President and CEO Gail McGovern. She shared her personal story about her struggle with breast cancer and provided memorable insights and inspiration to the audience. 
Next up was a unique modern dance performance by choreographer Stephen Petronio, though before he launched into it, he he was joined by yesterday’s speaker, Dr. Jacob Scott, who proceeded to place an IV line into Petronio’s left arm. Come again? Petronio explained that he had adapted his mentor’s so-called “intravenous lecture” to provide hydration to himself while exposing his own deep personal stories through narration and dance. Following the performance was another performance and call to action by a pair of Emory physicians, neurologist Jonathan Glass and neurosurgeon Nick Boulis. They spoke of their patients who suffer from the rapidly fatal disease amyotrophic lateral sclerosis (ALS) which inactivates their spinal cord motor neurons, leading to paralysis of lower extremities followed by their breathing systems. Drs. Glass and Boulis have been working with their desperate patients and biotech companies to research and develop promising stem cell transplantation therapies; however, due to the FDA’s regulatory definition of ‘acceptable risk’ they are unable to try such therapies in patients who need them most. The physicians acted out scenarios that exposed the roles and risks of each stakeholder – patient, biotech company, and FDA – and emphasized that if patients are willing to take the risk, which most of them are because the alternative is death, then they should have final say and thus be able to contribute to the development of these new treatments.
Next up was Dr. Otis Brawley, the chief medical officer of the American Cancer Society, who trained in oncology and epidemiology and discussed whether we were winning the war on cancer that was famously declared four decades ago. Key points include (1) while we’ve become better at treating the disease, currently over half of cancers are directly linked to poor lifestyle habits such as smoking or overeating, and (2) we need to step back and determine how we diagnose and understand cancer because we may be overscreening, overdiagnosing, and overtreating (he cited studies that reported that up to 25 percent of treated breast cancers and a staggering 60 percent of prostate cancers may turn out to be benign).
Speaking of diagnosing and treating disease, the following speaker was vascular surgeon and chief medical officer of Quest Diagnostics, Dr. Jon Cohen. He gave a fascinating talk about the driving forces of consumers – price, quality, and desire – and why none of them function correctly in our consumer-based medical system. Though good criteria for buying, say, a television, price and quality are poorly understood by patients because they either do not have access to or do not take the time to access the right information, such as the mortality rates of the hospitals they visit or physicians they see. In terms of desire, Cohen said “people do not want health-care” (the only exception of course being the patients who underwent approximately 10 million cosmetic procedures last year) and that we need to turn the system on its head so that it becomes “desire-driven” not “consumer-driven.” The session wrapped up with a Q&A with professional athlete couple, surfer Laird Hamilton and volleyball player Gabby Reece, who spoke about everything from their backgrounds to healthy lifestyles to relationship to parenting habits.
The final session of the day began with another – perhaps the most – memorable performance we’ve heard from spoken word artists Sekou Andrews and Steve Connell. They urged the audience to “GO!” and do exactly what we spent the last few days hearing about, the future of medicine and healthcare. Most memorably they called us to “find the cows” – an initially confusing, though very powerful call to action that referred to Dr. Edward Jenner’s thought process while he was walking and, after seeing some cows, realized that his patients who regularly handled livestock were not contracting smallpox (thus leading to the development of the smallpox vaccine). By saying “find the cows,” Sekou and Steve meant for us to keep our minds open to potential new developments for treatments to all of the medical problems discussed over the last few days at TEDMED.
Next up was best-selling author and broadcaster Dr. Ben Goldacre, whose call to action was to “find the missing data” – that is, to change the biomedical publishing industry so that they also publish negative results of clinical trials along with the positive. He provided stunning case studies of manipulation and mind-numbing statistics, such as the fact that in the last few years 37 of 38 trials (97%) with positive results were published whereas only 3 of 36 trials (8%) with negative results were published. After this heated talk was a brief song about carrying out an experiment followed by another Jay Walker exhibit; this time of some of the first public health data collected, including week-by-week death records that reflected the bell-shaped curve of epidemics and pandemics like the bubonic plague. The energy-packed day concluded with celebrity appearances from author and organic farmer Joel Salatin, who spoke against the mechanistic view society takes in manipulating life that we depend upon, as well as Katie Couric and Billie Jean King as mentioned earlier.
Innovative? Check. Imaginative? Check. Inspirational? Double Check. Just another day at TEDMED – stay posted for coverage of the last day and interviews to come!