With the saying, “All good things come to an end,” in mind, we’ve reached the final day of TEDMED 2012. The tenth session, and first of Day 4, began with a cameo by TEDMED co-creator and serial entrepreneur Marc Hodosh who stayed to emcee the session. 
First up was legendary cardiothoracic surgeon, Dr. Bud Frazier, and his colleague at the Texas Heart Institute, Dr. Billy Cohn. On a side note, we spoke with Dr. Frazier the day before and when we asked him about advice he would give to medical students and biomedical engineers, he echoed E.O. Wilson’s remark from yesterday: find an overlapping niche and purpose that you can fulfill extremely well. For him that was creating artificial heart pumps, starting first with the pulsatile flow model and then revolutionizing the field by transitioning to the continuous flow model. Drs. Cohn and Frazier began the talk by comparing the pulsatile design of heart pumps to the flapping-wing ornithopters in aviation history. In that analogy, the 747s of heart pumps are the next generation models they are working on that have minimal moving parts and essentially rely on an electromagnet that rapidly spins an Archimedes screw to pump blood throughout a patient’s body. Patients with this device are eerily living without a pulse, which could be confusing for first responders and may require patients to get medical tattoos that say “pulse-less heart pump inside.” This simple and elegant design is long-lasting and, according to the surgeons, is broadly applicable to the hundreds of thousands of patients with failing hearts. When asked about whole-heart transplants, Dr. Cohn responded with the memorable quote:
“Counting on transplants to solve the organ crisis is like counting on the lottery to solve poverty.”
Next up was computational biology professor Franziska Michor, who began by discussing her combined interests in mathematics and biology and how that led her to cancer research. Her primary interest is in providing a mathematical framework for cancer cell proliferation and the incidence of drug resistance-conferring mutations. This could provide oncologists an in silico clinical trial that allows them to develop drug dosing strategies that would halt or reverse tumor growth while avoiding resistance to chemotherapy. Her speech was followed by a brief Q&A between Jay Walker and Wednesday’s speaker and plant scientist, Howard Shapiro, about the future of farmed food and how genomics can help gain insight into developing more nutritious foods through traditional breeding techniques. Walker stayed up on stage for the final library exhibit: ancient medical textbooks from the 15th and 16th centuries that depicted the human body in beautiful detail. He explained one particular image of a dissection attended by an entire town – from medical students to elderly clergy – as representing a transition in human history because it opened up the doors of broadly accepted scientific inquiry.
The President & CEO of the Alliance for Aging Research, Dan Perry, came on next to discuss the history and future of geroscience. One particularly interesting (and ironic) historical fact he mentioned was that the American businessman and father of modern advertising, Albert Lasker, for whom the Lasker Awards for Medical Research is named, devised the campaign that helped Lucky Strike cigarettes appeal to women. In his defense, the dangers of smoking were not nearly as clear as they are presently, and his wife, Mary Lasker, helped the NIH expand its budget by a factor of 2,000 in four decades. The next talk was by Dr. Lynda Chin of the MD Anderson Cancer Center. In part related to yesterday’s talk by Dr. Ben Goldacre on the publication of negative results, as well as Wednesday’s talk by Dr. Jacob Scott on medical school “imaginectomies,” Dr. Chin’s speech called for a change in the culture of academia to promote researchers to take on high-risk, high-reward applied sciences projects. She resoundingly said that first-authorships are not the only way to demonstrate talent. Next was a brief presentation by the Cleveland HeartLab, who had been offering inflammatory testing (IT) to TEDMED delegates over the last four days. The IT results, which screened not only for C-reactive protein but also myeloperoxidase and lipid levels, showed that approximately 40 percent of the 335 TEDMED delegates had elevated cardiovascular disease risk with 10 percent having a risk for vascular thrombosis. 
The final speaker of the session was Dr. Atul Butte of Stanford, who gave a fantastic presentation that began by citing a Wired magazine article about how the data deluge is making the scientific method obsolete. Briefly, the idea is that we are entering into a stage where we no longer have to generate data samples to answer questions, but rather we must generate questions that can be answered by the tremendous amount of data we already have or are collecting. Dr. Butte discussed the possibility of bright high school and college students accessing large online medical databases and, like the dorm-room and garage entrepreneurs in computer and financial sciences of the last few decades, revolutionizing the field with new ideas and ways of doing things. Experiment outsourcing services are making this hypothetical increasingly possible because people no longer need their own labs to answer questions. He concluded by saying that “Data is power, data is revolution, data is frozen knowledge” and with ingenuity and diligence we can bring the “heat, light, energy to melt and release that knowledge to the world.”
The eleventh and final session of TEDMED 2012 began with another song by Jill Sobule about going to the gym. She was followed by the chief scientific officer of Genomind, Dr. Jay Lombard, who gave a brief talk about the importance of finding objective biomarkers for psychiatric conditions. 
Next up was Dr. Leslie Saxon, a cardiologist at USC whom we’ve covered multiple times before for her research on integrating technology and medicine. After providing statistics about implantable heart monitors she began discussing AliveCor’s iPhone ECG and how it has already helped her diagnose and help patients outside of the clinic. For example, she was able to monitor and notify a dangerously tachycardic Kenyan man who was in Mumbai at the time and encourage him to get medical care. A key message was that there may soon be a paradigm shift in healthcare delivery: rather than patients acting reactively and coming into the clinic only when something is wrong, physicians may be able to act proactively and reach out to patients before anything serious develops. Amazing.
Next up was Ali Ansary, a medical student at Rocky Vista University and co-founder of SeventyK, who gave an energetic speech about the next frontier in medical education: preventive medicine through behavior change.
Following him was author and chairman of the Institute for Functional Medicine, Dr. Mark Hyman, who spoke passionately about the rise of lifestyle-associated chronic disease – which he terms “diabesity” – not only in the developed world but also in the developing world. He provided an anecdote from his time in Haiti post-earthquake when he asked the director of a hospital what the most common medical condition people came in with prior to the disaster. Expecting to hear diarrhea or tuberculosis, he was shocked to learn that the answer was diabetes. Dr. Hyman then discussed the need to improve the nutrition and physical activity habits of people rather than buying into what he calls “pharmageddon.” He argued that medications are not only cost-ineffective compared to healthy lifestyle behaviors, but they also often have paradoxical side effects: for example, statins for heart conditions have been shown to cause diabetes, and diabetes medications have been shown to cause heart problems. He concluded the presentation by discussing his work with Dr. Oz and churches around the country on something called Project Daniel, which has helped church communities collectively shed hundreds of thousands of pounds and become healthier. It was an inspirational call to all of the TEDMED delegates to do more to promote active and healthy lifestyle behaviors.
The final wrap-up of TEDMED 2012 began with the appearance of CEO Jose Suarez, who thanked all of the sponsors and staff who made it possible. Jay Walker then gave an excellent conclusion to the conference by recapping many of the highlights of the last few days, from the insightful Q&A with 15-year old progeria patient Sam Berns to the passionate spoken word performances. Walker discussed what we had accomplished by attending TEDMED, namely breaking down the silos that all of us typically reside in and immersing ourselves into the imaginative, the innovative, and the inspirational. He alluded to next year’s conference, for which they have big plans such as streaming the proceedings to every single medical school in the world.
Registration for TEDMED 2013 has already begun and, based on how amazing this year’s conference was, Medgadget is already counting down the days.