Notes from TED. Some medical and health highlights.

I am back from Vancouver where I spent the week attending the annual TED conference. (As I mentioned yesterday, it was…eventful.) I’d like to share a few impressions with you, and some highlights that pertain to health and medicine.

TED 2024.

First, I was able to attend this five-day event thanks to a supremely generous gift from my friend, the brilliant writer, comedian, thinker—and Inside Medicine reader—Julia Sweeney. If you haven’t kept up with her work over the years, I highly recommend all things Julia. Her Substack is great, as are her books and shows. Her books are really good on Audible too (because you get to hear her read them, which is a plus.) And here’s a fun photo of us here in Cambridge, last year:

Julia and me. Photo credit: Michael Blum (Julia’s husband).

TED vibes.

I’ll admit to being a little nervous arriving at the conference. There are many TED offshoots but this was the big annual “main event.” People in the audience are frequently as impressive as those on stage. But there’s an amazing “openness” to the event. Everyone’s lanyard has their name in big letters and the culture is simply to say hi to any random person you run across and chat for a few minutes. This type of thing can be hard for me. I can be very shy and introverted or, alternatively, I can be the life of the party, depending on my mood. I contain multitudes, people. But I literally met my first fellow TEDster in the elevator and from there, I was off to a good start. I met lots of people from all over, with varying interests. Some of the conversations were truly interesting and unique. Others were pro forma. Can’t win ‘em all. Actually, my favorite moment in any of these conversations was with a some guy (who turns out to be a billionaire). He asked me something, and we quickly got into a real and in-depth conversation, cutting past small talk. After a few fairly substantive go-rounds, the conversation petered out just a bit—or at least reached a natural pause. Before it could get awkward, he just said, “Nice to meet you!” and he suddenly walked off towards a food truck nearby. This was part jarring—like the sudden end of a Monty Python sketch—and part totally awesome. Like, “Okay, we don’t need to draw this out any longer, but it was a really good exchange. Cheers.”

Another good thing: the “no phones in the theater” rule (for the most part) works nicely and there’s no coming-and-going during the talks. It really makes the atmosphere conducive for being “present.”

Some medical/health highlights from TED.

Here are some brief highlights from some talks that touched on medicine and health at TED 2024. (All of these talks will eventually be online, by the way.)

Protein folding solved by AI.

The structure of every protein determines what it does. But figuring out what proteins look like (and therefore, perhaps design some new drugs) has historically been very hard work. An AI project by Google called AlphaFold seems to be helping scientists tackle the problem in leaps and bounds. Apparently, it can now predict the shape of a protein with astonishing detail based on the amino acid sequence. I used to work in a lab at UCSF that tried to understand protein folding. The implications are massive here.

Digital Pills.

Can a digital pill replace endoscopy? It looks possible. Endoscopy—a fiberoptic camera that GI doctors snake down the esophagus into the stomach and beyond—is a fairly high-effort procedure, both for the patient and the doctors. At TED, we saw a live demo from two innovators who have developed a pill-sized camera that can be operate by remote control. One presenter swallowed such a pill, while the other (GI doc at the Mayo Clinic) controlled the pill. We all watched on screen, live, as the pill made its way down the guy’s throat. The views were decent. The views we saw are not yet at the level of modern endoscopy, but they were quite impressive. And the size of the pill impressed me. They’ve gotten this thing from impossible to swallow to fairly easy. And it comes out the other end with ease. (We did not get a demo of that part.)

Indigenous genetics.

We are still just beginning to unlock what the human genome has to say about our risk of disease and other factors in health. Data from indigenous populations are underrepresented in that field. A TED speaker highlighted the value of genomic health data from indigenous groups.

Reprogramming reproduction.

Everyone has a mother and father. At least so far. A researcher showed us how scientists are now able to reverse engineer reproduction so well that his team created eggs using reprogrammed cells from male mice which led to offspring which had two biological fathers (and no mother). Clearly, science is headed towards “we can do this.” Less clear to many are the ethics of whether we should. But arguments in favor of this, include rescuing endangered species and, also, helping people with infertility, and even same-sex couples who both want to be biological parents.

Prion diseases remain incurable.

A researcher who herself has a gene that means she will eventually experience a rapidly fatal neurodegenerative disease described the state of research on prions, the rogue proteins that cause it (and others like it). Interestingly, she shared that prior to her children being born, she and her husband used in vitro fertilization (IVF) to screen the embryos to make sure that their children would not inherit the gene from her (the odds were 50-50 for any embryo). I thought that was an ethical use of pre-implantation IVF screening.

Malaria could go away.

Can malaria be eradicated? A parasitologist from Burkina Faso working on this says yes. The idea is to introduce genetically modified mosquitos into the wild that will basically render the malaria-carrying species unable to survive. The modeling shows that once introduced into the wild, the whole process would not take very long. It’s incredible to consider, when you realize that there were over 249 million cases of malaria and over 600,000 deaths in 2022 worldwide, according to the WHO. Look, if this works, I am going to be very, very happy. The researcher said that the particular species of mosquito that transmits malaria is not important to the ecosphere. I hope that turns out to be true!

How to fight poverty more effectively. Get out of the way.

Poverty and health are intertwined. So while this last talk by a former member of Parliament in the UK was not explicitly about health, I saw the connection. Basically, his TED talk boiled down to one idea: if you want to help poor people in areas with hunger and terrifying poverty, don’t send UN trucks and well-meaning aide workers. Just send money. The data were compelling. The overhead goes away and people use the money in many positive ways that governments and NGOs couldn’t always predict. He said that a barrier to this approach was the idea that if you give people money, they’ll just “steal it,” rather than using it for the intended good. His rejoinder: with all the overhead and the incredibly bad return on investment from fancy aid programs administered by wealthy nations and organizations, we are the ones stealing the money. The idea of bypassing red tape and bureaucracies lines up with emerging data on the effect of cash infusions on the health of those living in poverty.

One last thing…

Okay this one was not a medical talk. It was just a thrill to hear a talk by the great artist Guo-Qiang Cai. His work has always fascinated me. I was “fan-girling,” as they say. Also, his talk demonstrated a wonderful AI tool. He gave his entire talk in Mandarin. A translator spoke in English into the PA system. But it converted the translator’s English into a very good rendition of Guo-Qiang Cai’s actual speaking voice. So, what we essentially heard was Guo-Qiang Cai’s voice, as though he were speaking to us live in English. It was really, really cool.

All in all, I left TED with a lot to think about, and a bunch of new connections. And that was exactly why I went. I hope you enjoyed getting a sense of my journey.

Thanks again, Julia!