The initial fare at TEDMED 2012 whet my appetite for the sessions that followed.
Howard-Yana Shapiro, a plant scientist wizard, focused on how to improve nutrition in crops, rather than just the volume of the yield, and the coming crisis in feeding the world’s population. When he began, my cynical side thought, “Here comes Monsanto and their genetically modified crops and patent wars.” I couldn’t have been more wrong.
Instead, he noted that every hour 300 children die of hunger and one quarter of children suffer stunting, and that plants can be genetically engineered to be more nutritional. He told about cocoa and the African Orphan Crops Consortium, working with UC Davis and Mars corporation to sequence the genomes of cacao and 100 traditional African food crops.
Such sequencing accelerates traditional breeding by enabling a more precise cross with plants that have desired attributes. Breeders can then examine if the new plant has the desired attributes without waiting years for the plant to grow to maturity.
I was in disbelief when he said that the cacao genome would be freely open to all via the Public Intellectual Property Resource for Agriculture (PIPRA) and the Cacao Genome Database. Other African crop genomes will follow. (Irony: this important project to revitalize orphan crops was announced by UC Davis’ own Linda Katehi, perhaps better known for the nutritional pepper spray use on her campus). When I asked Shapiro about the unusual step of making all these genomes public, he responded, “I don’t see the logic of restricting 6 ½ million small farmers.” That alone was worth my trip to Washington, D.C.
Dr. Tom Frieden’s talk also grabbed my attention. Perhaps it was his self-deprecating manner, saying, “When you see how doctors practice medicine, you realize how resilient” people are. Or perhaps his stories of battling tuberculosis in India and New York. And he told of his father’s dying words to him, when he boasted that he wanted to become the best health commissioner, being “How would you know?” These experiences led to his conviction that you must have a feedback loop to assess your impact if you are to succeed. And his observation, “Public health does best when it helps people see the faces behind the numbers,” is well-demonstrated by the CDC’s great new hard-hitting anti-smoking ads.
Jacob Scott’s admonition that the direction of medicine is in trouble because medical schools select students based on MCATs, not imagination, resonated with me as well. He should also add the push for conformity in thought and the pressure to “get along” to his list. Unfortunately, I was confronted with several examples of the issues he highlights in my own medical education. From day one of my training, when I questioned the need for personal identifiers on what was pitched as an anonymous survey, I was branded as “having trouble with authority figures.”
Asking hard questions and having a different perspective is something med schools try very hard to beat out of you. I was also criticized for being a “hand holder” and spending too much time with my patients. Scott similarly warned about schools focusing on requiring encyclopedic knowledge, rather than seeing connections, thus detracting from the human side of being a compassionate physician, as well as stifling creativity.
E.O. Wilson also hit a nerve, noting that many of the scientists are …”mathematically semi-literate” and that bright students turned away because they are afraid of failure…are mathphobes. Guess he was looking at me. He spoke of the “stillborn PhDs,” who never really go on to do great things because they are too narrowly focused and specialized.
Instead, in a grandfatherly manner, he encouraged young scientists to become more interdisciplinary and advised, “The best strategy for success in science is to bring two disparate subjects together.” In science, “what is crucial…is imagination…leading to hard work…[You must] think like a poet, work like a bookkeeper.”
Albert-László Barabási gave a provocative perspective comparing the human genome project to a map of Manhattan. He noted that a number of different diseases are manifested by a defect with the same underlying gene. We may know a little about isolated genes or bits of information, but are limited by not understanding the connections between them. He stressed that we need to stop focusing on isolated organs and instead, need to focus on the networks between our cells.
A few of the other TEDMED talks were tougher; I’ll discuss some of these meatier topics in a later post. Save room for dessert, too!
Images: Frieden talk by Chris Seper at MedCity News, other photos provided by TEDMED.
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