Tag Archives: medicine

How Mohammed Dalwai’s mobile triage app could save lives around the world

Mohammed Dalwai shares his idea for a Mobile Triage App at TEDGlobal 2014. Photo: Ryan Lash/TED

Mohammed Dalwai shares his idea for a Mobile Triage App at TEDGlobal 2014. Photo: Ryan Lash/TED

Every day, emergency room workers use triage to prioritize patient care — but exhausted personnel in under-resourced hospitals can easily make deadly errors in diagnostic tests and symptom scoring. South African emergency room doctor Mohammed Dalwai witnessed such avoidable tragedy firsthand while working with Médicins sans Frontières in Pakistan. He resolved never to let it happen again.

Dalwai urged MSF to apply a standard triaging system — the paper-based South African Triage Scale —  in his emergency room in Pakistan. This led to an 86% improvement in successful triaging, and to MSF adopting this standard in emergency rooms around the world. It also led to a big idea for Dalwai. Now, with The Open Medicine Project (TOMPSA), he and his team have made an app that is freely available. They are planning to roll it out across many regions.

Here, Dalwai tells the TED Blog about the app’s development, and its possible future uses — including the ability to track realtime data of disease outbreak.

How did you end up joining Médicins sans Frontières and creating the Mobile Triage App?

I actually always wanted to be a biomechanical engineer! But then I started studying medicine, and fell in love with it after the third year, when I began seeing patients. That was it for me. I finished med school at Stellenbosch University, and afterwards went into rural medicine. I went into the bush to work at Manguzi Hospital, on the border of Mozambique and South Africa.

There, I met an MSF doctor, who told me about the organization. The idea of going into low-resource settings and helping to make an impact in the system appealed to me, and I wanted to experience medicine outside of South Africa. So I went on multiple missions with MSF — to Pakistan, Afghanistan, Libya, Syria, Haiti and Sierra Leone.

It was in Pakistan in 2011, on my first assignment, that I saw patients dying due to incorrect triaging. One day, I lost a patient. A young woman, 22 years old, came in with abdominal pain. She was incorrectly triaged, and she waited for eight hours. She had something called an ectopic pregnancy — a pregnancy outside the uterus — and she was bleeding internally. When I found her, she was barely alive, and we tried everything to resuscitate her. But she died — and it really affected me. She was a woman, she was sidelined, she was put in a corner — no one cared, no one did the triage properly. If she’d been triaged correctly, we would have realized she was pregnant, and we would have prioritized her.

From that day on, I became determined to sort out the triage problem. I was part of a team that implemented the South African Triage Scale in my emergency room, and it was the first time it had been used in an MSF hospital. It was the first time the South African Triage Scale was ever implemented in Southeast Asia.

Villagers from Hhohho, Swaziland, wait outside to get their vitals taken before seeing a physician or dentist. Photo: Air Force Staff Sgt. Lesley Waters

Villagers from Hhohho, Swaziland, wait outside to get their vitals taken before seeing a physician or dentist. Photo: Air Force Staff Sgt. Lesley Waters

What is the South African Triage Scale?

It’s a paper-based system based on a composite score — including complaints and vital signs — and one of the only triage scales made for the developing world to evaluate both adults and children. It was developed in a small but busy hospital in Cape Town in a low socio-economic area in response to massive patient loads, understaffing and high death rates. It was introduced in 2008, and shown to be effective when implemented.

MSF had never had a standard triage system in place before this. We lobbied hard for change and standardization. They let us try it, and we did a study that showed a successful implementation. It was at that point that MSF realized how valuable it was, and they started implementing it in every emergency center around the world.

But this is not necessarily a one-size-fits-all solution. The South African Triage Scale (SATS), being relatively new, has been tested extensively in South Africa, but not yet rigorously tested outside of the country. I’m now working on my PhD, documenting the SATS’s validity and reliability in other sectors and countries. For the last two years, I’ve been collecting data on the SATS and how it’s been implemented globally. We proved that it works in Pakistan, and we proved that it works in certain African countries. But Afghanistan and Haiti are different. What are those differences, and how can we adapt the system for local circumstances? In Sierra Leone, for instance, there was a massive malaria population, which has lower hemoglobin levels. Because of that, the triage scale wouldn’t pick up certain patients, so we would have to adjust one or two discriminators after research so that the triage scale is more sensitive for these people. Small things like that make a massive difference in patient care.

A look at TOMPSA’s Mobile Triage App. Photo: Makkia da Costa

A look at TOMPSA’s Mobile Triage App. Photo: Makkia da Costa

Why create a mobile app, when it sounds like the paper-based system works very well to correct the possibility of human error?

Even though the SATS works, it still needs to be implemented correctly across a variety of situations, so we need to standardize the format to further avoid human error. Health care workers are trained to various degrees across different countries. One of the easiest ways to standardize things is through technology. When I came home from Pakistan, I discussed my experiences with my friend Yaseen Khan. Together we decided we had to tackle health system problems using technology — and that’s how we formed The Open Medicine Project (TOMPSA).

When you look at the way the nurses or health care workers make mistakes, it’s usually one of two areas: it’s either they don’t understand the discriminator — so the first symptom that the patient comes in with. The paper-based version of the SATS offers no additional information, whereas a mobile app can. They also make mistakes in calculation. In the SATS, the vital signs are all linked to a composite score, and each one is different. So say, for example, you have a heart rate of 98 beats per minute, that’s zero point. If you have a heart rate of 101, that’s one point. It’s easy to make mistakes, and a massive number of errors are happening in that scoring system alone. So digitizing systems offers more information as prompts for medical care depending on the score. Nurses were forgetting to do pregnancy tests, for example.

The app is essentially a digital checklist. Checklists make massive differences in both the airline aviation industry as well as in medicine. You see the same thing with the WHO surgical checklist. It saves lives.

To read the full interview, visit the TED Blog >>>

 

Eye phone: How a TED Fellow’s new app could help restore sight to millions

Andrew Bastawrous shares the idea behind Peek at TED2014. Photo: Ryan Lash/TED

Andrew Bastawrous shares the idea behind Peek at TED2014. Photo: Ryan Lash/TED

Around 39 million people in the world are affected by blindness — 80% of which could be avoided if people had timely access to diagnosis and proper treatment. The problem is that in many developing countries, most eye care providers are in cities, while the majority of patients live in hard-to-reach rural areas. To bridge this gap, London-based opthalmologist Andrew Bastawrous created Peek — an app and adapter that turn a smartphone into a comprehensive, easy-to-use, accurate eye-exam tool. Peek makes eye tests affordable and easy to administer, bypassing the need for expensive, fragile equipment. (Watch his TED Talk, “Get your next eye exam on a smartphone.”)

Bastawrous developed and extensively road-tested Peek during a research expedition in Kenya, and has now launched an Indiegogo campaign to set up manufacturing process for the Peek Retina adapter, which allows health workers to peer into the eye and capture images for diagnosis. If successful, Peek will soon be rolled out worldwide with the help of eye NGOs. Here, he tells the TED Blog how his own childhood experiences with poverty, inequality and impaired vision led him to devote his life to restoring sight to the world.

How long has Peek been in development?

I’ve been working on it for around three years, and the team came together about two years ago. We’re now at the point where we’ve got a proven, tested prototype, and we want to make it available. We’ve had so much demand — over 4,000 eye organizations in 180 countries are asking to use it, and we want to make it available and keep the cost low. We evaluated options, and recently won the TED Mazda Rebels award. We’ve used the majority of that to fund set-up of the manufacturing pipeline to develop the adapter, and that takes us to about the halfway point.

You grew up in England. What made you want to practice in developing countries?

I was born in York, but my parents are both from Egypt, and I grew up between cultures. We spent most of our holidays in Egypt, and I always felt a little like I didn’t know where home was. When I visited Egypt, I witnessed things I didn’t see in the UK. My father’s a doctor, and he’d always visit the village where he grew up whenever we went back. He would be inundated with requests for medical attention.

It really inspired me, the way he never said no to anyone. Once a woman complained to him that she couldn’t have a child. My father, who is actually a bone doctor, did some general blood tests, and said, “Look, as far as I can see, everything’s okay.” When we went back the following year, she had a child with her — and everyone else in the region who couldn’t have babies started coming to see my dad to get it sorted out.

So I think seeing such things left me with a very deep sense of inequality. I also realized I’d had a very privileged upbringing. Within Egypt, my relatives are quite well off. But my grandma lived on the first floor, and the family that lived on the basement floor were effectively working for the apartment block. There was a kid there the same age as me, and every year we’d diverge more in terms of our opportunities. When we first met, we both just wanted to play football, but by the time we were 18, he’d had a kid, and his opportunities were very limited. Meanwhile, I had so many fantastic options for my university, career. It just seemed deeply unfair.

A Peek healthcare worker examines patient in her own home. Photo: Courtesy of Peek

A Peek healthcare worker examines patient in her own home. Photo: Courtesy of Peek

But why eye care?

I grew up very short-sighted. I was at the bottom of my class until I was about 12, when my mum dragged me kicking and screaming to the optician’s and insisted I get some glasses. Suddenly I could suddenly see everything perfectly — and I don’t think I’ve ever forgotten that moment. So I’ve always been struck with the power of being able to have sight returned, the impact it can have. After that, I started to do well at school, and was better at sport. I looked a bit more geeky, but I was doing better in a lot of other ways.

So it had always been in my mind at medical school to go into ophthalmology. I spent my summer holidays traveling, visiting people who were doing eye care in resource-poor settings, and just really fell in love with the possibilities. There are so many people who are unnecessarily blind. Had they been living in the UK, they would have never have gotten to the point where their vision problems were anything more than a nuisance. I knew this would be how I’d spend my life.

Untreated eye disease must be a problem in many developing countries. Why did you choose to focus on Kenya?

I’d worked in various countries short term, from Uganda, Sierra Leone and Madagascar to Peru and Belize. I then got the opportunity to work at the International Center for Eye Health on a PhD program. We were to do a large trial in Kenya, for which we’d be required to take lots of expensive equipment to 100 different locations to try and work out why people were going blind. I was excited because I knew this research would result in change, as opposed to only lead to papers and publications.

The most common causes of blindness are the same everywhere in the world — with cataract the top cause. In developing countries, blindness is an issue of access to healthcare, not usually a result of weird and wonderful tropical diseases, although there are certain infectious diseases that are more prevalent in Africa.

To read the full article, visit the TED Blog >>>

Imagination in health and medicine? 11 fresh ideas from the TEDMED stage

Nassim Assefi directed the stage program for TEDMED 2014, a conference which brought out unexpected ideas in medicine—like how one can help cancer patients with a pink tutu. Photo: Sandy Huffaker Jr.

Prosthetics as sculpture, the maternal benefits of breast milk, Cuba’s radical approach to free medical education. These are just a few of the subjects tackled at TEDMED 2014: Unlocking Imagination, hosted last week simultaneously in San Francisco and Washington, DC, with a stage program directed by TED Fellow, physician, novelist and activist Nassim Assefi. On two stages over three days, 2,000 conference-goers and 80 speakers and performers gathered for an idea exchange on a vast range of subjects relevant to innovation in health and medicine.

A medical edition of the TED conference that was founded in 1995 (it’s now independently owned), we asked Assefi what made this TEDMED different from those in the past. “This was the most diverse TEDMED conference in its 19-year history,” she said. “We had slightly more women than men, more ethnic and international diversity than ever before, and a tremendous variety of fields. We didn’t point this out much during the program, but the impact of it did not go unnoticed.”

This year, it was truly a global event. “The conference was livestreamed to 146 countries free of charge, which felt like a democratizing coup,” Assefi added. “I believe being radically open is the wave of the future.”

In that spirit, for those of us not lucky enough to attend, the TED Blog hand-picked 11 of the most intriguing ideas presented on the TEDMED stage, and asked Assefi to tell us more about them. Find them below, grouped by theme. And for more speaker highlights, visit the TEDMED blog.

Photographer Kitra Cahana turned her lens on her father to capture his experience with “locked-in” syndrome. From “Father; Inchoate, Sub-Planetary, Protozoan.” Montreal, Canada, 2013. Photo: Kitra Cahana

Reverberations in global health

1. Financial compensation for living kidney donors may be a reasonable way to handle the kidney shortage crisis. Iran is the only country in the world that has legalized the sale of kidneys from living donor volunteers. The government-endorsed program has been in existence for over 25 years and is implemented by non-profit health charities. Bioethicist Sigrid Fry-Revere went on an underground research mission to investigate, and her counterintuitive research reveals that the Iranian solution may be the least exploitative, most equitable policy given the current kidney shortage crisis.

2. Offering a free medical education could have big benefits for the world. Cuba-based American journalist Gail Reed describes a radical experiment of solidarity undertaken by the Cuban government — founding the largest medical school in the world that freely provides training to students from the Global South, educating them to be humanitarian, holistic doctors. That experiment in radical generosity is now paying off: there’s a disproportionately high number of Cuban doctors currently volunteering in the Ebola crisis in West Africa, and these new graduates are quickly becoming a significant force in combating the global physician shortage in low-income countries.

Bob Carey started taking self-portraits of himself in a pink tutu for his wife when she was diagnosed with breast cancer. Now, his images cheer others up too. “Jump”, from the Pink Tutu Project. Photo: Bob Carey

Art therapy

3. Creativity can come from something as difficult as ”locked-in” syndrome. Photographer and TED Fellow Kitra Cahana is well known for documenting marginalized communities. (Watch her TED Talk, “A glimpse of life on the road.”) But when her beloved father, a rabbi, suffered a stroke resulting in “locked-in” syndrome — he could move only eyelids but had full cognitive functioning — she turned her camera inward to document his experience. Instead of pitying himself for his near total paralysis, Rabbi Cahana finds spiritual liberation and blinks out long, transcendent sermons to Kitra and her family, who steadfastly watch over him. The result of their three-year journey is a new visual art form that’s both eerie and beautiful, matching her father’s extraordinary spiritual resilience.

4. A photograph can be grown. Zachary Copfer was a microbiologist working for a pharmaceutical company who fell out of love with his profession and escaped to art school instead. In the process, he invented bacteriographs, a new photographic process where he literally grows photographs in living bacteria — and, paradoxically, reignited his passion for science.

5. A pink tutu can be a tool in cancer treatment. Another photographer, Bob Carey, turned to self-portraits as a form of self-soothing when his wife Linda was diagnosed with an aggressive form of breast cancer. His favorite prop was a pink tutu, which cheered him from the bleakness of Linda’s diagnosis and made her laugh. When she shared his images with her fellow chemotherapy patients and saw the comfort they offered, The Tutu Project was born. Today, Bob continues to do ballerina self portraits all over the world, donating a portion of profits to help cancer patients cope with health care expenses. The hilarious and beautiful photos remind us that sometimes, laughter heals best.

To read the full post, visit the TED Blog >>>

A listening cure: PatientsLikeMe gives patients voice in clinical trial design

Paul_Wicks_Informal_Headshot_Low-Res

Until now, patients have had very little to do with the design of clinical trials — even though they’re key to their success. Online patient networking and research platform PatientsLikeMe, is changing all that. Last week, PLM launched a new service that lets pharmaceutical companies collaborate with patients to create clinical trials that serve their needs — amplifying the chances of success for both researchers and patients. We asked PLM’s Paul Wicks to tell us more about why this is a game-changer for medical research.

Why is this latest development so important?

The most important path to creating new medical breakthroughs is the randomized clinical trial (RCT). Hundreds, sometimes thousands, of patients volunteer to be randomized for either a new treatment, placebo or existing treatment in these large and expensive studies. This isn’t an easy process. It can be bewildering for patients to wade through incomprehensible medical jargon in order to understand what they’re signing up for. Then they have to undergo frequent testing — which includes traveling frequently to the hospital, and undergoing blood tests, brain scans, biopsies, and other procedures, some of which can be time-consuming, painful, or both. They also have to adhere to a strict set of rules while they take part.

All the while, patients don’t know if they’re on a treatment that might help or harm them, or whether they are in fact being systematically fooled by a placebo. Patients have misgivings about how they perceive the experience will be, too: 22% of cancer patients in a survey reported they thought they would be “treated like a guinea pig” in a clinical trial.

So not surprisingly, only 5% of patients take part in clinical trials. While the trials cost millions of dollars, 1 in 5 enroll no patients whatsoever, and half miss their targeted number of participants.

How has PatientsLikeMe solved this problem?

We’ve developed the first rapid, robust, representative system that lets patients have a voice in the design of study protocols. RCTs have been designed by doctors and scientists ever since the mid-20th century — when they first started being used widely – with input from regulators (like the FDA) and the business interests of pharmaceutical company sponsors, but with none from patients themselves. We share patient data from PatientsLikeMe with people designing RCTs to identify exactly the type of patients that might be eligible for a study, and get their input and feedback on every aspect of trial design.

We address everything from the language used to describe the study (e.g., “What does this word mean? Patients would probably say X instead of Y”) to the outcome measures used (e.g., “This outcome measure doesn’t really sound like something that’s important to me. Why aren’t you measuring pain?”), and aspects of the study design that are a “deal-breaker” for patients (“If I have to travel more than 20 miles to come to the study center, I’d refuse to take part”).

How will this help those who design clinical trials, and, more importantly, patients?

By listening to patients in advance, study designers can be proactive rather than reactive. They’ll more likely be able to minimize the burden on patients, and they’re far more likely to recruit enough patients to take part in their study. They’ll also glimpse the types of problems their study is likely to encounter, leaving them better prepared to shift gears or make changes if necessary.

This all seems very sensible. Why has no one ever done it before? 

A lot of people in industry are afraid of listening to patients, worried that there might be legal or regulatory barriers to speaking with them. We’ve also lacked ways to quickly gather systematic quantified and qualitative feedback from a large number of patients. That’s something patient-powered research networks like PatientsLikeMe have only recently enabled.

There have been some smaller-scale attempts to get patient input, but these have tended to be within academia, and still aren’t widely used.

What’s your ultimate goal? 

We’re trying to make it so fast, simple, and downright useful to gather this type of data that we’ll move from the status quo (almost nobody uses quantitative patient research in the design of trials) to it being the norm in the next five years.

It’s all a part of our mission to put the patient voice in the decision-making heart of healthcare — and as you can tell, I think it’s pretty exciting! This year, there will be hundreds of clinical trials that fail to meet their targets because of off-putting study protocols that place too much burden or confusion on patients. By bringing a patient focus into the system we could streamline research, increase recruitment rates, and maybe even get faster cures. Just by listening.

To find out more about Paul Wicks and PatientsLikeMe, visit the TED Blog >>>

A snapshot of recent survey results, based on 1,600 patients' views. Image: PatientsLikeMe

A snapshot of recent survey results, based on 1,600 patients’ views. Image: PatientsLikeMe

 

 

 

 

 

The Rare Genomics Institute celebrates World Rare Disease Day 2014

Last Friday was World Rare Disease Day – an event launched in 2008 to galvanize public awareness and research momentum for rare diseases. In the United States, a disease is considered rare if it affects fewer than 200,000 people. Yet there are more than 7,000 known rare diseases. This ratio means that there’s little funding for rare-disease research, so even getting a diagnosis can be a years-long odyssey, never mind treatment. Rare disease patients — the majority of them children — too often fall through the cracks.

“World Rare Disease Day unites all the thousands of rare diseases to speak with one voice and raise attention to this often overlooked sector of health research,” says Jimmy Lin, a TED Fellow and the founder of the Rare Genomics Institute, which serves the needs of patients suffering from rare diseases.

To mark World Rare Disease Day, the RGI has released a free ebook — Diagnosing Rare Diseases: Giving Families Hope Through DNA Testing, Crowdfunding, and Access to Experts — for families of those living with rare diseases. Written by Ana Sanfilippo and Jimmy Lin, the 150-page resource features interviews with the first-ever patients to be diagnosed using genomic sequencing, inspiring stories of those whose lives have been saved, advice for parents, as well as conversations with respected rare-disease physicians and genomics experts.

“We hear so many amazing stories of heroic parents fighting for their rare disease children and the amazing scientific results from this work that we think it will inspire many families in the trenches,” says Lin. “Plus, we get a lot of questions about the science and thought an information guide may be helpful.”

RGI helps individual patients with by giving them access to state-of-the-art genomics sequencing technology (see video, above). It offers a crowdsourced platform to raise funding for research, pairs patients with doctors and researchers, and helps families tap into the support of other affected families. To learn more about the Rare Genomics Institute, read the TED Blog’s conversation with Lin.

Illuminating an illness without end: Fellows Friday with Jennifer Brea

Blog_FF_JenniferBrea

Three years ago, Jennifer Brea, then a PhD student in political science, was struck down by what appeared to be a severe flu. It turned out to be the beginning of a long illness — including neurological dysfunction and extreme exhaustion — that she has yet to recover from. Discovering that the medical community did not recognize her illness and worse, dismissed it as hysteria, Brea did her own research and discovered that there is a name for what she was experiencing: myalgic encephalomyelitis (ME), a devastating, misunderstood and ignored disease affecting millions.

To call attention to the plight of those suffering from ME, Brea is making a film, titled Canary in a Coal Mine, to offer firsthand insight into what it feels like to live with this debilitating disease. Its Kickstarter campaign, launched just days ago, has already almost met its target, a clear indication that the time for this film has come. Here, Brea tells the TED Blog her story.

When you did you become ill?

I first became ill in 2010. I had 104.7-degree fever that lasted for 10 days. A year later, in 2011, I was at a restaurant with some friends. The check came, and I couldn’t sign my name. I would look at the paper, and I couldn’t move my hand. I found I could no longer draw curves or circles. Over the course of the next day, I went in and out of periods where I would be totally lucid, I could understand everything anyone was saying to me, but became completely unable to think in any language. It was a little like being a dog. I could understand speech, and I could conceive of things in general impressions, and pictures, but there was no monologue in my head.

That sounds terrifying.

I think in some ways it was actually a blessing, because I could not be afraid of what was happening to me. Something I’ve learned is that in order to experience fear, you have to be able to project the future, and for that you need language. You need the future tense. You might even need the past tense. I was living in the present, and that was all that there was.

My neurologist told me I was suffering from conversion disorder: my illness was caused by stress or a psychological trauma that I might not even recall. Although my physical symptoms were real, there was no organic basis of my illness. It was all very Freud.

This doesn’t speak very well for doctors.

Since starting the film, I’ve become much more sympathetic to doctors, because it’s really not their fault. It’s a product of the training they have received. They’re taught to cure the world’s known diseases, and my disease is not taught in medical school. So if they can’t put me in a box, they can’t treat me.

That said, I was shocked. It was the first time I had ever been not taken at my word, had ever been condescended to like that. I started to wonder, well, if I — with my personality and education and privilege — am being treated that way by all of these doctors, what the hell is happening to people all around the country? What would happen if I were walking into a public clinic, or if I’m in a rural area? And what if I’d been someone who hadn’t had the education to feel like I can challenge people who are in positions of authority? This is one of the reasons I wanted to make this film.

Brea and her husband Omar. Still image from Canary in a Coal Mine.Brea and her husband Omar. Still image from Canary in a Coal Mine.

What were you doing while all this was happening?

Throughout this experience, I was doing tons of research. I was getting my PhD in political science, but I was also doing a master’s in statistics, and so had some training to know how to read and understand research. My husband and I were just constantly reading. We’d go to the doctors with stacks of journal articles, and they would say, “Where did you find that, on the internet?” I’d say, “Yes I did. Here’s an article from Nature, here’s an article from Science, here’s an article from the New England Journal of Medicine.” I had one doctor actually make a guttural sound when he tossed the articles on the floor. I mean, I was really naïve — I didn’t realize that most doctors don’t read medical journals. It’s just not the way that system works. Even one researcher — who was a fantastic doctor — was not reading anything on my illness that was being done by people in other fields. She was an infectious disease doctor, but she wasn’t reading what’s happening in immunology, or people who were looking at gastrointestinal stuff.

What’s the difference between chronic fatigue syndrome and ME?

Chronic fatigue syndrome was a name created by a CDC committee in 1988 in response to a series of outbreaks, most notably the Incline Village, Nevada, outbreak of 1984. It was really unfortunate, not just because the name sucks, but because one, there was already an internationally recognized name for the disease — myalgic encephalomyelitis — and two, the definition they came up with said nothing about some of the most severe neurological and autonomic dysfunction many of us experience. So some of our most devastating symptoms are said to be impossible because they are not in the definition.

The horrid name and the exclusion of those symptoms means that many people diagnosed with CFS probably don’t have ME. A lot of people want to lump chronic fatigue syndrome, fibromyalgia and so on into one group. I think we need to study people who are patently self-similar in terms of their histories and symptoms and stop saying “It’s all very murky” when the murkiness is man-made.

That said, I do, at the end of the day, think that strict diagnostic criteria are useful for clinical trials but harmful for treatment. Our bodies don’t obey medicine’s boundaries, and I don’t think many diseases do either. For example, I’ve learned through my own research that what is probably happening to me right now, physiologically, has a lot in common with certain features of multiple sclerosis, HIV, diabetes and certain genetic mitochondrial diseases. Now, who would ever think those literatures should be speaking to each other? But they should be.

To read the full interview, visit the TED Blog >>>