Prevention

Update: 2017-07-219
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We often know how to plan for the future, but find it hard to take the necessary steps. This hour, TED speakers challenge the inevitable and explore what to do today to prepare ourselves for tomorrow.TED speakers include neuroscientists Daniel Levitin and Rebecca Brachman, writer (and neuroscientist) Lisa Genova, epidemiologist Seth Berkley, and behavioral economist Daniel Goldstein.

Following script is auto-generated by Speech to Text Technology:

support for this NPR podcast in the following message come from lime ade corporate wellness technology designed to inspire healthier happier and more productive employees with a lime aid you can be a change maker and engage or workforce visit lime a dot com forward slash change to learn how this is the Head Radio Hour each week groundbreaking Ted Talk chat with Ted Technology Entertainment Design Design at Stanford never delivered and it had conferences around the world gift of the human imagination we had to believe in impossible the true nature of reality beckons just beyond those talks those ideas adapted for radio the NPR guy rise so get started today with Daniel Everton Daniels a neuroscientist and low Daniel its rise here thanks for joining us guy thanks for having me out unexpectedly when the first things Daniel told us about was a recent car accident I was stunned by the accident I got whiplash I got a concussion but I had rehearsed the situation that if I get an accident like this the first person I'm in a call is my doctor and let him know and then I'm going to call the police and ask them to come out because I'm not in any kind a state where I can evaluate what I need or don't need you actually even though you had not been an accident before this you had rehearsed this exact scenario in the past the exactly the reverse the scenario if I'm in an auto accident what do I do you know I didn't think about it more than five minutes then I just kind of filed it away Okay that's what I'ma do I think that the principle for all of us is that because in moments of panic were not at our peak we need to think ahead and train ourselves although I wasn't always that way just you know it comes to forty five years of making mistakes and realizing that the amount of time it takes to clean up the mess is a lot more that the amount of time it takes to front load of effort on the show today ID is about prevention how the things we do today can change the way we experience tomorrow and white sometimes so hard to do this stuff we know we should do like planning ahead for a crisis or exercising or eating the right things because the future even the near future I often seems so far away but some people but some people are just different like neuroscientist Daniel Everton who started to think about how he might prevent or even mitigate future crises after one particularly bad day here's Daniel on the Ted stage a few years ago I broke into my own house I had just driven home it was around midnight and the dead of Montreal winter I'd been visiting my friend Jeff across town and the thermometer on the front porch read minus forty degrees and as I stood on the front porch fumbling in my pockets I found I didn't have my keys so I quickly ran and tried all the other doors and windows and they were locked tight I thought about calling a locksmith at least I had my cell phone but at midnight it could take awhile for a locksmith to show up and couldn't go back to my friend Jeff's house for the night because at an early flight to Europe the next morning and I needed to get my passport my suitcase so desperate and freezing cold I found a large rock and I broke through the basement window crawled through I found a piece of cardboard and taped it up over the whole opening figuring that in the morning the airport I called my contractor and ask him to fix it now I'm a neuro scientist by training and I know a little bit about how the brain performs under stress it releases course all that raises your heartrate module eight adrenaline levels and it clouds your thinking so the next morning when I woke up on too little sleep worrying about the hole and a mental note that I had to call my contractor in the freezing temperatures and the meetings I had upcoming in Europe my thinking was cloudy but I didn't know it was cloudy because my thinking was cloudy and it wasn't until I got to the airport check in counter that I realized I didn't have my passport in the chill in the I mean what happens to us when we're faced with crisis any kind of crisis that requires us to make a quick decision is what is the sort of the physiological response to that well so the brain developed mechanisms for coping with stressful and potentially dangerous events and the brain releases cortisol the stress hormone it's partly mediated by a structure that's part of the reptilian brain the main Villa and this causes a Cascade of really interesting things to happen to your brain chemistry first thing that happens is adrenaline is released and then your body tries to conserve energy in order to deal with the crisis at hand and saw a bunch of stuff shuts down like your digestive system your reproductive drive shuts down you don't need to be feeling reproductive is the nice word for it here in system shuts down and unfortunately rational systematic thought shuts down and you start dealing from your God and your instinct but there's most of the jams we get in the reptilian brain isn't equipped to handle and I started wondering are the things that I can do systems that I can put into place it'll prevent bad things from happening or at least if bad things happen will minimize the likelihood of it being a total catastrophe but my thoughts didn't crystal eyes until about a month later I was having dinner with my colleague Danny condom and the Nobel Prize winner and I somewhat embarrassed Lee told him about having broken my window forgot my passport and any shared with me that he'd been practicing something called prospective hindsight also called the pre mortem now you all know at the post mortem is whenever is a disaster team of experts come in and they try to figure out what went wrong right well in the pre mortem Danny explained you look ahead you try to figure out all the things that could go wrong and then you try to figure out what you can do to prevent those things from happening or the damage so part of the practice of the pre mortem is to recognize that under stress you're not going to be it your best and you should put systems in place the hook for this idea of a pre mortem this has actually become habit like a part of your life if you regularly imagine in advance how you would react to different kinds of problematic scenarios yes it's exactly that and you know the military uses this ideally we hope that the government uses this kind of thinking and pilots they go through endless exercises about what you're going to do in various stressful scenarios so that you don't have to think it becomes automatic certainly successful businesses tend to do that but there's no reason it can trickle down to the rest of us right sure I'll give you an example so today here in Washington I'm in Los Angeles I woke up in San Francisco this morning and I took in an early flight this morning knowing that if that flight for some reason was canceled or delayed there was a backup flight than I could take and still make it to talk to on time the other thing I knew was that if all flights were canceled there was a studio airport that I could run into and do the interview from there and we booked some backup time there so it was just a matter of thinking ahead can I take control to make sure it doesn't upset the schedule but I mean I think the it seems like it despite all of the planning that we could do for a variety of scenarios and situations we just have to accept that we can't prevent the things that will happen to us whatever they may be I agree and again what I come back to on this is you can't control the future you can attempt to influence it but some of the things you can control are your responses review can be ready to think about something because you thought about it before you can be ready to adapt and adjust you can learn skills whether they're practical or psychological you can practice and that when the unexpected happens you can roll with punches eleven ten is a neuro scientist his most recent book is called The organize my thinking straight in the age of information overload you can see his entire talk to that calm so the first thing that might come to mind when you think of prevention disease especially infectious disease like malaria or yellow fever cholera or Ebola and a bowl of course was all over the news just a few years ago when an epidemic started in a small village in Guinea in West Africa and then started to spread to neighboring countries by the time health workers got the outbreak under control it killed more than eleven thousand people the number of scary that one was very scary cause it not only killed people but then kill the health workers who are taking care of them and of course people bleed out and you know it's a horrible death says epidemiologist Seth Berkley I'm the CEO of coffee the vaccine Alliance excess organization works to get vaccines to people in developing countries to prevent or at least a slowdown the spread of epidemics because today unlike any other time in human history and outbreak in a small village in Africa can spread around the world in a matter of days well absolutely so I mean I often have dinner in Nairobi you know breakfast in London and lunch in New York and that's within the incubation period of dozens and dozens of infectious diseases people travel and therefore viruses travel and so your head threat from diseases that appear anywhere on the world the best thing to do is to try to prevent those diseases at the source of where they might spread the fact that public health workers manage to get Ebola epidemic under control at all and prevent millions from dying is actually astounding especially because there is still no approved vaccine for the disease no way to prevent it in the first place and why well here's Seth Berkley steak from the Ted stage we fear Ebola because of the fact that it kills us and we can't read it but wait a second why is that we've known about Ebola since nineteen seventy six we've known what it's capable of we've had ample opportunity to study it in the twenty four outbreaks that have occurred and in fact we've actually had vaccine candidates available now for more than a decade why is it that those vaccines are just going into clinical trials now this goes to the fundamental problem we have with vaccine development for infectious diseases it goes something like this the people most at risk for these diseases are also the ones least able to pay for vaccines this leaves little in the way of market incentives for manufacturers to develop vaccines unless there's large numbers of people who are at risk in wealthy countries it's simply too commercially risky vaccine development is expensive and complicated it can cost hundreds of millions of dollars to take even a well known antigen and turn it into a viable vaccine and this is really the point the sad reality is we develop vaccines not based upon the wrist the pathogen poses to people but on how economically risky it is to develop these vaccines in just a moment we'll hear from Seth Berkley and how despite this flight system we can prepare for and maybe even prevent future outbreaks and I rise near listening to the Ted Radio Hour from NPR the o Everyone Just a quick thanks to two of our sponsors who help make this podcast possible first to the degree courses plus video learning service here's a clip from Wharton professor Jonah burgers course how ideas spread the word of mouth is the primary factor behind twenty to fifty percent of all purchasing decisions consequently their person Acacia has a huge impact on whether products ideas and behaviors become popular watch this or any course with a free month trial when you subscribe to the monthly plan that great courses plus dot com slash radio our thanks also to racket mortgage by Quicken loans racket mortgage gives you confidence when it comes to buying a new home or refinancing your existing home loan with rock a mortgage you can apply simply can't understand all the details so you can mortgage confidently get started or racket mortgage dot com slash ideas Jess kept equal Housing lender licensed in all fifty states and MLS consumer access dot org Number thirty thirty eight and one more thing before we get back to the show Ted has a new podcast called sincerely X where you'll hear ideas from Anonymous ten speakers like an ex con who thinks he can make prison more effective or a doctor who thinks her fatigue was the reason for a patient's death you can find sincerely X now on Apple podcasts heads Android app or wherever you get your podcasts the kids that Ted Radio Hour from NPR and I rise and I should say ideas about prevention and stamina to go epidemiologist Seth Berkley explained why we still don't have vaccines for diseases that have been around for a long time like Ebola and the answer vaccines cost a lot to produce and is no real incentive for companies to make them for developing countries if the vaccines are being made based upon the risk for commercial production versus on the risk of disease that is a problem and so you know who we have collectively as a decision of the private sector's was going to produce or drugs and vaccines we have to acknowledge that and put incentives in place to make sure that they produce vaccines on you know from that era not necessarily just the ones that are commercially most viable do think we would be better off if this really was led by the government I think the challenge and governments and we've seen this in many parts of Sciences that you know there's a danger of central planning the danger of not having the power of innovation and I think what's interesting about when you know the commercial sector moves forward on something is often multiple companies move forward the same time sometimes when you're lucky you know you get multiple products coming out and you can choose the best of those these are all the good parts of having industry do it and you know it's critical for us to continue to innovate if we're going to ultimately have the products we need our own assets as there are ways to strike a balance between what's cost effective and what's morally right the first is to recognize when there's a complete market failure in that case if we want facts seems we have to provide incentives or some type of subsidy we also need to do a better job at being able to figure out which are the diseases that most threaten us we have to stop waiting until we see evidence of disease becoming a global threat before we consider it as one every year we spend billions of dollars keeping a fleet of nuclear submarines permanently patrolling the oceans to protect us from a threat that almost certainly will never happen and yet we spend virtually nothing to prevent something as tangible and evolutionary certain as epidemic infectious diseases and make no mistake about it it's not a question of if but when these bugs are going to continue to evolve and they're going to threaten the world and vaccines are our best defenders by the the even when the sex scenes do exist to treat the disease there's another big problem and actually getting the vaccines to the people who need them most and so for that what we have to have his systems because vaccines don't deliver themselves so first of all you know initially some of the vaccines were very inexpensive their old vaccines they've been produced in large quantities and the challenge in those cases is getting them to the people who need them so you need a healthcare worker you need a cold chain that's to keep the vaccines refrigerated when they go out of the field you need a data system to record those vaccines and then also be able to follow up if they're being Miss ten people don't necessarily live near health centers so you know woman walks ten km to get to a health center to vaccinate her child and there's no vaccine there are there's no health worker there it's unlikely the next day she's going to pick up and turn and walk another ten km so one of the problems then is is having the systems in place and something that we're actively working on the other problem is the newer vaccines Stuart quite expensive and with limited quantities and the challenge was how do you get that costs down and make them affordable for the developing world and that's what my organization got the vaccine Alliance was created to do de do we know how many kids die from this disease every year today we estimate that there's about one point four million children that are still dying of vaccine preventable diseases wow it's unbelievable but there are stun vaccination programs that have been pretty effective rate like like for polio yes um in a moment that's extraordinary in that there's only been three cases of polio this last year and so we're right on the brink potentially of eliminating that disease and this is what happened with smallpox smallpox was a terrible disease that used to kill millions of people and that was completely eradicated nineteen seventy seven and the effects of these when we are able to eradicate a disease are enormous cost savings you can not only stop vaccines but of course you get rid of the terrible disease burdens that these diseases hat so upset right now and we know that climate change is happening great and it will get worse in the future of the oceans will rise and sea ice will melt and human migration patterns will change as a result of all this and yet even though we know the sayings it doesn't necessarily move enough of us to change or to prevent this from happening it seems like the scene at the same challenge when it comes to preventable diseases and diseases that could potentially be cured or eliminated through vaccination well I mean you know they're connected so if you look at Africa we're going to see a quadruple in the population by twenty one hundred as you have to feed that population is going to mean pushing towards the forest than having destruction of forest and contact between people and you know animals in the forest and so if you take all of that together which you're going to say is this going to be lots more infectious diseases that are going to occur in these settings the challenge then is Is the world going to focus on this you know either from a humanitarian point of view because it's the right thing to do but if not from a self preservation point if you think that it's in some ways part of human nature like the most wired this way to to react rather than to prevent if you look at the paradox of prevention I mean you know people will do anything to be treated Melville overvalued treatment even when you have treatments that are not very good they want to try them if they have a serious disease on the other hand you know they won't do much to try to prevent it we see Matt and smoking we've seen the head and seat belt use we've seen that in many different risky things and so I think it is a fact of human nature that people under value prevention and over value the treatment and dealing with disease the chest Berkeley is CEO Guy B vaccine alliance by the way they are actually on track to license one the world's first Ebola vaccines by the end of twenty seventeen You can hear Seth full talk show today ID is about prevention the things we can do today to prepare ourselves for tomorrow the whole even when it comes to something that doesn't seem preventable at all the something like an old timers if we're too scared to talk about Alzheimer's to the point where we can make it seem like it doesn't exists because we're not gonna talk about it well it's awfully hard to cure something that doesn't exist this is Lisa Edge another if we can all think back to when people would say the word cancer and we didn't discuss it and if your neighbor had cancer we talk about it we can look at our neighbor that person basically excluded from community and something changed in the world of cancer and people began talking about it we mention the name to where the rope looped ribbons we go for walks we bake casseroles and we bring those people back into community that's no accident that we have treatments and survivors now for cancer if we're going to get to a point where we have treatments and survivors her all summer as we need to be in conversation about it today Lisa is a neuroscientist turned writer I write novels about people living with neurological diseases and disorders and a couple years ago she wrote a novel about all timers it's called Still Alice still Alice is about Harvard professor and she is diagnosed with early onset Alzheimer's disease and so the book is about boats trying to find out what your worth is if you've placed all of your worth and what you do and what you do is think for a living and it's very cerebral intellectual if you can A longer be that the book is about who am I And how can I matter what I have something like Alzheimer's and as Lisa points out of tremors is something that will probably impact all of us in one way or another here's the section over on the Ted stage the how many people here would like to live to be at least eighty years all ya I think we all have this hopeful expectation of living into old age let's project out into the future your future use and let's imagine that we're all eighty five now everyone looking to people one of you probably has Alzheimer's disease or maybe you're thinking Well it won't be me then OK you are a caregiver so in some way this terrifying disease is likely to affect us all part of the fear around Alzheimer stems from the sense that there's nothing we can do about it despite decades of research we still have no disease modifying treatment and no care so if were lucky enough to live long enough all Summers appears to be our brains destiny but media doesn't have to be what if I told you we could change the statistics literally change our brains destiny without relying on it here our advancements in medicine the use of said using the all timers can be prevented an eye due to next and so outside we think of all summers begins with the buildup of a protein called amyloid beta and that build up can take ten to twenty years before it reaches a tipping point that then causes the disease to become symptomatic and sold like heart disease rate like so we know that when you go for your physical and get your blood pressure taken and your cholesterol checks with a blood drive will be tested for heart disease and the hope is that if they catch that he can do something about that either through its Titans diet exercise prevents you from getting heart attack in ten years or twenty years likewise with all summers there are things that we can do to keep those family plaque levels from reaching the tipping point and they involve similar fangs like like Soul one of the big discoveries in recent years has to do is sleep so in slow wave deep sleep argh li'l sells rents cerebral spinal fluid to our brains and did this clears the way a lot of the metabolic waste that accumulated during the business of being awake and one of the things that can clear ways and my beta and so you can imagine that while you're sleeping this is being so swept away the deep cleanse for the brain if you're not getting enough sleep you're going to wake up in the morning with family beta levels not cleared away and so it's going to pile up we know that cardiovascular health is so important he notes that your heart is also going to be good for your brain and likewise in that's not good for her is probably not going to be good for preventing Alzheimer's in so you can imagine that if you did nothing you'll reach that tipping point sooner so in terms of preventing the disease now maybe you've bought yourself an action ten fifteen twenty years what after that employ what are the symptoms look like so are the symptoms change from like say for example there's this phenomenon called tip of the tongue where you're trying to think of someone's name like olives that was that Noah begins with ass I know it has two syllables but can't come up with it maybe you're driving your car four hours later and suddenly the word or name pops and you had all its era and we all experience the stiffer the time in fact the average twenty five year old experiences three to four tips of the town a week this does increase a little bit with age but with something like all summers when a word drops out you don't have the first letter and you don't know the number of syllables and it doesn't come back in a couple of hours so the beginning symptoms of Alzheimer's will often be words that are lost and not found it is having trouble remembering what happened a few minutes ago so short term memory gets compromised its language its memory it's cognition it's being able to think through complex tasks are making mistakes at work on if there's a procedure that involves ten step she might not get through all the way to the tenth step he'll be unable to complete it said those mistakes start happening with Alzheimer's people what happens if you've already reached that tipping point yeah so in thinking about summers it's helpful to think of sin absence says Sapp says are the places where neurons communicate and that's what under attack in this disease and the good news for us humans is we've got a lot of these synapses average brain has a hundred trillion so while they're under attack with Alzheimer's we've got a lot of backup connections that we could potentially take advantage of the loose after all the time for a process called natural plaster City every time we learn something new we're creating and strengthening new neural connections new sap says in the non steady six hundred and seventy eight nuns all over the age of seventy five in the study began followed for more than two decades they were regularly given physical checkups and contests when they died their brains are all donated for
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Prevention

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