Okay, TED MED 2009, after a 5-year hiatus for this conference series, is now over....and I, for one, am glad the conference is back. I'm mentally exhausted as I force myself to pound out these thoughts on the flight back to Portland. The Thursday and Friday sessions brought forth different messages and perspectives about healthcare, and I realize that part of the magic of the event is the juxtaposition of so many aspects of healthcare next to one another. One minute, it is tissue engineering, the next minute is robotics, next is prosthetics, then behavior change, then medical visualization, then consumer health technologies like the cell phone and telehealth, then stem cells, then personalized genomics. It's part of the reason that it's so important for participants to stay for the whole event (and thankfully, most of them...even the "stars"...do). You need to experience the systemic view that TED MED ultimately gives you by journeying to so many different healthcare places over four jam-packed days.
One of the things I really like about TED MED is that the "e" in TED stands for "entertainment," and the theme of this particular conference was around "story." The juxtaposition of amazing breakthroughs in cancer research (with deeply technical talks that I could only admire from a surface level understanding) next to great song, poetry, and passionate story-telling challenged both mind and heart. Performer Sekou Andrews opened the conference on Tuesday with a vibrant performance piece that somehow synthesized and foreshadowed the titles and concepts for almost all of the talks we would see over the course of the week. Eric Mead and David Blaine doing magic tricks on stage and around the event was not only fun but evinced an undercurrent of mystery and questioning-of-your-beliefs that helped undercut the seriousness and surety of the science. Dave Stewart came up on stage yesterday with a fabulous singer and violinist who played the song they wrote for the "Stand Up for Cancer" campaign, as well as his classic "Here Comes the Rain Again." And there were great songs throughout all the days from singer, song-writer Jill Sobule.
Here were some of my other highlights and impressions from the rest of the meeting:
· Dean Ornish and Deepak Chopra had an interesting dialogue about prevention, behavior change, mindfulness, and other "low tech" ways to better manage health, which was a refreshing counterpoint to all the "high tech" interventions the day before. Dean's comments that healthcare reform is too focused on payment and too little on chronic disease prevention, even reversal, was music to my ears. He showed data about how lifestyle changes--more than just diet--can actually reverse heart disease, even contribute to slowing the progression of prostate cancer and the reduction of PSA numbers.
· Deepak, whose comic timing and wit on stage must rival any of the major comedians on late night television, talked about having to change our "memes" (ideas that replicate) beyond traditional models of medical care. He talked a lot about how we have to use "cyberspace" like Twitter and social media to reach critical mass on messaging about very different notions of healthcare. Both of them gave evidence that "genes are our predisposition but not our fate," and that lifestyle, attitude, and meditation can directly affect how long we live and our disease states. Deepak gave compelling evidence that the real epidemics on our hands are depression, loneliness, and isolation (he said we are 3 to 7 times more likely to die if socially isolated)...that isolation is at the root of our suffering and illness. Really made me feel like so much of the work we've focused on at Intel around building Social Health and community through new technologies will be a game-changer some day.
· Peter Diamandis, head of the X-Prize foundation, announced the five 10,000 patient cohorts they will fund with Wellpoint with the goal of having three-year innovations/interventions that can measurably improve community health. I love this. Rapid innovation. Measurable. Results oriented. On a large scale. We need more of this.
· Andrew Weil gave a talk on Integrative Medicine, with two opening points that really resonated with me: 1) that we only give lip service to health promotion and prevention because all of our industry is focused on disease treatment; and 2) that our interventions have come to depend on increasingly expensive technologies. Hey, I work for a "high tech" company, but so many of the pilots of personal health technologies Intel has done are simple, inexpensive, "low hanging fruit" opportunities to do disease prevention, early detection, or behavior change with the broadband, PCs, cell phones, and home sensor nets we've already got. It does seem that we, as a culture, are addicted to the expensive and complex, and dismissive of the simple and affordable. It's almost as if we don't believe we are getting good care unless it is expensive, complex, and high tech.
· Dean Kamen gave what was probably my favorite talk of the week. He stood simply, almost uncomfortably, on the side edge of the stage. And, in a calm, almost imperceptible voice, told amazing stories about building robotic prosthetics for veterans who were returning from Iraq and Afghanistan with leg and arm amputations. The stories, the videos of these amazing machines that they engineered in record time, and the results of seeing these amazing veterans wearing these things to feed themselves a grape or spoon full of cereal...were, simply, astounding. Dean's entire presentation made me question the way we fund and do science in the United States. If every researcher was presented with real-world needs, deadlines, and high expectations to drive useful, usable results, we would advance the basic science and the impact so much faster.
· Rick Satava gave a whirlwind prediction of "what's next?" for the frontiers of medicine. But first, he began with something I think was even more important, though not as sexy as cool videos, demos, and images of high tech gadgets of the future. He began with a compelling critique of the scientific method. He reminded us that the scientific method needs to be kept in its place--that it is a human creation at a moment in time in history--and that we need to innovate our methods of doing science as we progress. He suggested that we're overdoing the use of "randomized clinical trials" as the means to answer a lot of our questions. I really agree with this. Much of the work on home health solutions Intel is working on are being treated, scientifically and financially, as if they are drugs being tested in drug trials. There's an unquestioned assumption that the proof required for the viability and efficacy of these new kinds of technologies should be driven by the same old scientific methods and randomized controlled trials we've been doing for decades now. We need to innovate the scientific methods and measurables, as much as the technologies themselves.
· Sanjay Gupta shared powerful images and stories from his time on the front lines reporting in Iraq and Afghanistan, as well as more recently around H1N1. The most memorable moment was his description of having the army team come running to ask him to step out of his reporter role to do brain surgery on a wounded solider, and all he could find was a Black & Decker drill used to put their sand tents together to do the surgery. Wow! (The solder lived and is doing quite well now.)
· Dave Gallo & Billy Lange on the closing day showed first ever videos from robot submarines sent down to the depths of the ocean where they discovered hundreds of new life forms in places that scientists were convinced no life could survive. The camera would pan to these underwater "lakes" of toxic chemicals a couple of miles beneath sea level--with pressures unimaginable--and as the biologists would say "nothing could possibly live here," you'd see strange fish, sponges, crabs, sea spiders, and many un-namable creatures frolicking and swimming around down there. Which is to say: we don't know nearly as much as we think we know...even when all the "experts" claim that we do. Message to me: keep on questioning, keep on challenging, keep on searching. And remember that at one point the experts were absolutely convinced that the world is flat!
So why have I spent two blogs on TED MED when most people have probably never heard of it? No, I'm not getting kickbacks from the conference organizers or anything like that, but in full disclosure, Intel was a sponsor. It's because the conference challenged me, made me think, made me question what I know and what I assume about healthcare, medicine, the mind, and the body. Some of that questioning would be a good thing for all of us to take with us into our debates about healthcare reform. And some of the systemic thinking in this conference--from breakthrough ways to do diagnostics, grow organs, or personalize treatment to important reminders to drive behavior change, heal holistically, and look at the body and mind as an ecosystem that needs to be in balance--needs to become woven into the public debate about healthcare reform. After this week, even more than before, I am convinced that healthcare reform is doomed if we persist only in reforming the insurance system. There is so much more to be done...so much more to be talked about...than the public option. And many of the minds and stories in that conference room this week should be brought onto the national stage to help us transform how we treat our policies, ourselves, our minds, and our diseases. If only the whole country had the luxury and time for such a provocative and important dinner party.