Storytelling with Impact

Kasley Killam: Why social health is key to happiness and longevity @ TEDNext 2024

February 20, 2025/in Health, Mental Health, Relationships, Social Health, TED Talk/by Mark Lovett

During the week of October 21, 2024 I had the pleasure of attending TEDNext, held in Atlanta. The event is a new initiative from the folks who produce the TED Conference. There were enlightening talks, insightful discussions and revealing discovery sessions. This post is the fifth in a series highlighting some of my favorite talks.

When I was growing up, physical health was talked about as the key to longevity. Are you eating a balanced diet? Getting enough exercise? And getting an annual checkup? Mental health was rarely talked about in any depth, and the notion of “social health”, well, I can’t recall ever hearing it mentioned.

Over the next decade, I see our cities and neighborhoods being designed with social health in mind, where vibrant gathering places foster unity and community builders are empowered to bring them to life.

So I was intrigued with Kasley Killam took the stage at TEDNext to talk about the importance of social health, and what each of us can do to strength it. Her story reminded me that I don’t spend enough time reaching out to friends as a way to keep important relationships alive and vibrant. And it inspired me to dig deeper on the topic.

I discovered the general concept is not new, as the World Health Organization made mention of social well-being in their constitution. But it never seemed to get its due until the 2020 pandemic. That’s when there was a noted increase in attention being paid to the effects of isolation and lack of social interaction.

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. ~ Preamble to the Constitution of the World Health Organization, signed July 22, 1946

And in a recent paper entitled: On social health: history, conceptualization, and population patterning, David Matthew Doyle and Bruce Link define their idea of social health “...as adequate quantity and quality of relationships in a particular context to meet an individual’s need for meaningful human connection.“

How do you see your own level of social health? To what extent is your personal story affected by the interactions that you have with other people? As I’ve talked about in the past, threads from the stories we’ve heard become woven into the tapestry that defines our true nature. And when we cut ourselves off from the diversity of narratives that surround us, we limit the richness of our own story.

Transcript

So, a couple years ago, a woman I know, who I’ll call Maya, went through a lot of big changes in a short amount of time. She got married. She and her husband moved for his job to a new city where she didn’t know anyone. She started a new role working from home. All the while managing her dad’s new diagnosis of dementia. And to manage the stress of all this change, Maya doubled down on her physical and mental mental health.

She exercised almost every day. She ate healthy foods. She went to therapy once a week. And these actions really helped. Her body got stronger. Her mind got more resilient, but only up to a point. She was still struggling, often losing sleep in the middle of the night, feeling unfocused, unmotivated during the day. Maya was doing everything that doctors typically tell us to do to be physically and mentally healthy. And yet, something was missing.

What if I told you that what was missing for Maya is also missing for billions of people around the world, and that it might be missing for you? What if I told you that not having it undermines our other efforts to be healthy and can even shorten your lifespan? I’ve been studying this for over a decade and I’ve discovered that the traditional way we think about health is incomplete.

By thinking of our health as primarily physical and mental, we overlook what I believe is the greatest challenge and the greatest opportunity of our time, social health. While physical health is about our bodies, and mental health is about our minds, social health is about our relationships. And if you haven’t heard this term before, that’s because it hasn’t yet made its way into mainstream vocabulary. Yet, it is equally important.

Maya didn’t yet have a sense of community in her new home. She wasn’t seeing her family or her friends or her co-workers in person anymore. And she often went weeks only spending quality time with her husband. Her story shows us that we can’t be fully healthy, we can’t thrive if we take care of our bodies and our minds, but not our relationships.

Similar to Maya, hundreds of millions of people around the world go weeks at a time without talking to a single friend or family member. Globally, one in four people feel lonely. And 20% of adults worldwide don’t feel like they have anyone they can reach out to for support. Think about that.

One in five people you encounter may feel like they have no one. This is more than heartbreaking. It’s also a public health crisis. Disconnection triggers stress in the body. It weakens people’s immune systems. It puts them at a risk, greater risk of stroke, heart disease, diabetes, dementia, depression, and early death.

Social health is essential for longevity. So, you might be wondering, what does it look like to be socially healthy? What does that even mean? Well, it’s about developing close relationships with your family, your friends, your partner, yourself. It’s about having regular interaction with your co-workers, your neighbors. It’s about feeling like you belong to a community.

Being socially healthy is about having the right quantity and quality of connection for you. And Maya’s story is one example of how social health challenges come up. In my work, I hear many others.

Stories like Jay, a freshman in college who’s eager to get involved in campus yet is having a hard time fitting in with people in his dorm and often feels home. homesick.

Or Serena and Ally, a couple juggling the chaos of young kids with demanding jobs. They rarely have time to see friends or spend time one-on-one.

Or Henry, recently retired, who cherishes time with his spouse, and yet feels untethered without his team anymore and wishes he could see his kids and grandkids more often.

These stories show that social health is relevant to each of us at every life stage. So, if you’re not sure where to start, try the 531 guideline from my book. It goes like this. Aim to interact with five different people each week to strengthen at least three close relationships overall and to spend one hour a day connecting. Let’s dig into these.

So, first, interact with five different people each week. Just like eating a variety of vegetables and other food groups is more nutritious, research has shown that interacting with a variety of people is more rewarding. So, your five could include close loved ones, casual acquaintances, even complete strangers.

In fact, in one study that I love, people who just smiled, made eye contact, and chitchated with a barista felt happier and a greater sense of belonging than people who just rushed to get their coffee and go.

Next, strengthen at least three close relationships. Okay, we’ve all heard of a to-do list, but I would like to invite you to write a to-love list. Who matters most to you? Who can you be yourself with? Make sure that you invest in the names of at least three of the people that you write down by scheduling regular time together, by showing a genuine interest in their lives and also by opening up about the experiences that you’re going through.

And I’m often asked, does it have to be in person? Right? Does texting count? Studies have shown that face to face is ideal. So do that whenever possible. But there are absolutely benefits to staying connected virtually.

And last, spend 1 hour a day on meaningful connection. Okay, if you’re an introvert right now, you’re probably thinking, “One hour sounds like a lot.” I get it. It might be surprising, but I’m actually also an introvert. However, keep in mind that just like getting 8 hours of sleep at night, the exact amount that’s right for you personally might be higher or lower.

But if you are thinking that 1 hour a day sounds like way too much because you’re just way too busy. I challenge you. Adults in the US spend an average of 4 and a half hours each day on their smartphones. So instead of scrolling on social media, text a friend. Instead of reading news headlines, write a thank you card. Instead of listening to a podcast, call a family member.

Maya put this into practice by scheduling recurring hangouts with the new local friend that she made, by attending community events and dropping cards off in her neighbors mailboxes, by planning trips to see family and inviting friends in other cities to come visit.

And bolstering her social health made more of a difference than focusing solely on her physical and mental health ever could. And I know this because Maya is actually me. I am so passionate about sharing tools to be socially healthy because honestly I need them too. And the 531 guideline is one way that we can be proactive and intentional about our relationships. And that is really the point. Be proactive and intentional about your social health.

So zooming out beyond the steps that you and I take individually together, we need to shape a society that thrives through social health.

Over the next decade, I envisioned educators championing social health in schools. And just like kids build their physical muscles in gym class, they’ll exercise their social muscles in connection class.

Over the next decade, I see our cities and neighborhoods being designed with social health in mind, where vibrant gathering places foster unity and community builders are empowered to bring them to life.

Over the next decade, I believe that social health will become as ingrained in our collective consciousness as mental health is today.

Because not that long ago, mental health was a taboo topic shrouded in stigma. And now public figures talk openly about it. There’s an entire industry to support it. And more and more people think of going to therapy like going to the gym. In this future, loneliness will subside just like smoking subsided when we recognized and treated it as a public health issue.

In this future, I hope that social health will become so deeply woven into the fabric of our culture that no one needs the 531 guideline anymore. So to get there, make relationships your priority, not only for you, but also for the people you love.

Because the beauty of nurturing your own social health is that it naturally enriches the social health of everyone you connect with.

Thank you.

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Olivia Remes: How to cope with anxiety @ TEDxUHasselt

January 10, 2024/in Biology, Health, Mental Health, TEDx/by Mark Lovett

While mental health was once a topic rarely talked about in public, thankfully the stigma continues to fade away and issues are now discussed more often in forums such as TED/TEDx events. In her talk at TEDxUHasselt, Olivia Remes gives the audience a few tips on how to cope with anxiety. We’ve all felt anxious at some point in our life – most likely, many times – but in these cases the feeling goes away once the situation that caused our anxiety has passed. On the other hand, anxiety disorders are of a more serious nature.

An anxiety disorder is different from “normal” anxiety. “Abnormal” anxiety is defined by excessive and persistent worries that don’t go away, even when there’s nothing to be stressed or nervous about. With an anxiety disorder, people usually try to avoid triggering situations or things that worsen their symptoms. – Healthline Media

Olivia is primarily talking about those people affected by anxiety disorders, but the techniques that she presents have much broader application. Watch her talk, then come back to review her transcript, as well as the comments I’ve made. Notice how she begins with a story, then moves to an explanation of the topic, before shifting to the suggestions regarding how to deal with anxiety.

Transcript (my notes in red)

Olivia invites the audience into a pair of situations that may be familiar to a lot of people.

Imagine that you’re getting ready to go to a party. You feel excited, but also nervous, and you’ve got this feeling in your stomach almost like another heartbeat.

There’s something holding you back, holding you back from getting too happy. “No, you mustn’t get too happy. Better to be cautious, otherwise, something bad might happen.” You start wondering, “Who should I talk to when I get there? What if no one wants to talk to me? What if they’ll think I’m weird?”

When you arrive at the party, someone comes up to you and starts talking with you, and as this is happening, your mind starts racing, your heart begins pounding, you start sweating, and it feels almost like you’re dissociating from yourself, like it’s an out-of-body experience, and you’re just watching yourself talk.

“Keep it together,” you say to yourself, but you can’t, and it’s just getting worse. After a few minutes of conversation, the person you’ve been speaking to leaves, and you feel utterly defeated. This has been happening to you in social situations for a long time.

Or imagine that every time you go out, and you’re in crowded places, you feel this panic starting to arise. When you’re surrounded by lots of people, like on a bus, you start to feel hot, nauseous, uneasy, and to prevent this from happening, you start avoiding a lot of places which makes you feel lonely and isolated.

You or the person in both of these scenarios have anxiety disorders. And what I can tell you is that anxiety is very common, much more than people think. Right now, one in 14 people around the world have an anxiety disorder, and each year, it costs over 42 billion dollars to treat this mental health problem. To show you the impacts that anxiety has on someone’s life, I will just mention that anxiety can lead to depression, school dropout, suicide.

There are a few ways to quote statistics, and in this case, Olivia decided to say, “one in 14 people”. That calculates to 7.1%, and she could have decided to quote that statistic instead. Is one or the other easier for you to understand? Is one way more impactful than the other?

It makes it harder to focus, and to hold down a job, and it can lead to relationship breakdown. But a lot of people don’t know this. That’s why, a lot of times, people sweep anxiety under the rug, as just nerves that you need to get over, as a weakness. But anxiety is so much more than that. A reason why so many people don’t think it’s important is that they don’t know what it is. Is it your personality? Is it an illness? Is it a normal sensation? What is?

That’s why it’s important to differentiate what is normal anxiety, from what is an anxiety disorder. Normal anxiety is an emotion that we all get when we’re in stressful situations. For example, let’s say, you’re out in the woods, and you come face-to-face with a bear. This will probably make you feel a little bit anxious, and you’ll probably want to start running like crazy. This anxious feeling that you get is good because it protects you, it saves you, and it makes you want to hightail it out of there, although maybe it’s not such a good idea to start running when you see a bear. I really don’t think you can outrun a bear.

Anxiety helps us meet our deadlines at work and deal with emergencies in life, but when this anxiety emotion is taken to the extreme, and arises in situations which don’t pose a real threat, then that’s when you might have an anxiety disorder.

For example, people with generalized anxiety disorder worry excessively and constantly about everything going on in their lives, and they find it very difficult to control this worry. They also have symptoms like restlessness, fear, they find it hard to fall asleep at night, and they can’t concentrate on tasks.

It’s often the case that when presenting a scientific topic to the public they will only have a general, and sometimes minimal, level of knowledge about it. In this situation, there’s not only a need to describe anxiety disorder, but to differentiate it from our normal anxious reaction to a specific situation. If you’re story involves a technical or complex subject, not just those based in science, think about how you can explain the topic clearly to an audience in a short period of time.

In spite of whatever kind of anxiety you might be suffering from, there is something that you can do to lower it. It works, and it’s simpler than you may think. All too often, we’re given medication for mental disorders, but it doesn’t always work in the long run. Symptoms often come back, and you’re back to where you started.

So here’s something else to consider. The way you cope or handle things has a direct impact on how much anxiety you’re experiencing, and if you tweak the way you’re coping, then you can lower your anxiety. In our study at the University of Cambridge, we showed that women living in poor areas have a higher risk for anxiety than women living in richer areas. These results didn’t surprise us, but when we looked closer, we found that women living in poor areas, if they had a particular set of coping resources, they didn’t have anxiety, while women living in poor areas without these coping resources had anxiety.

When addressing topics involving health, it’s important to back up your recommendations with research – studies, experiments, clinical trials, etc. In this talk, I would have preferred that Olivia provide some details regarding the study she mentions. How many people were studied? Over what period of time? How was the study conducted? This could be done in a couple of sentences and would create a stronger foundation for her story, in my opinion.

Other studies showed that people who had faced extreme circumstances, who had faced adversity, been through wars and natural disasters, if they had coping resources, they remained healthy and free of mental disorders, while others, facing the same hardships but without coping skills went on a downward spiral and developed mental disorders.

Beyond the examples given in the opening of the talk, this represents an important addition. Wars and natural disasters happen in many countries, and the effects on those who live through them can be serious. Considering the current state of the world, she could have added climate change to the list, as it will affect everyone.

So, what are some of these coping resources, and how can we use them to lower our anxiety?And before I dive into what they are, I’d like to point out – and I think this is so interesting – you can develop these coping resources or coping skills on your own through the things that you do; you can take charge of your anxiety and lower it, which I think is so empowering.

This is where the story pivots from explaining the problem, to presenting the solution. By also mentioning that people can utilize the coping resources on their own, Olivia captures our attention, as we now know that something tangible is coming up. The essence of any impactful talk is how the audience will benefit from the message.

Today I’ll be talking about three coping resources, and the first one is feeling like you’re in control of your life. People who feel like they’re more in control of their life have better mental health. If you feel like you’re lacking in control in life, then research shows that you should engage in experiences that give you greater control. I’ll show you what I mean.

Do you sometimes find that you put off starting something because you just don’t feel ready enough? Do you find it hard to make decisions, like what to wear, what to eat, who to date, which job to take up? Do you tend to waste a lot of time deciding what you might do while nothing gets done?

A way to overcome indecision and this lack of control in life, is to do it badly. There’s a quote by writer and poet GK Chesterton that says, “Anything worth doing, is worth doing badly the first time.” The reason why this works so well is that it speeds up your decision-making and catapults you straight into action, otherwise, you can spend hours deciding how you should go about doing something, or what you should do.

This can be paralyzing and can make you afraid to even begin. All too often, we aim for perfection, but never end up doing anything because the standards that we set for ourselves are too high, they’re intimidating, which stresses us out, so we delay starting something, or we might even abandon the whole thing altogether. Do it badly frees you up to take action.

I mean, you know how it is. So often, we want to do something perfectly. We can’t start until it’s the perfect time, until we’ve got all the skills. But this can be daunting and stressful, so why not just jump into it, just do it however, without worrying if it’s good or bad? This will make it that much easier to start something, and as you’re doing it badly to finish it, and when you look back, you’ll realize, more often than not, that actually, it’s not that bad.

A close friend of mine who has anxiety started using this motto, and this is what she said, “When I started using this motto, my life transformed. I found I could complete tasks in much shorter time periods than before. Do it badly gave me wings to take risks, to try something differently, and to have way more fun during the whole process. It took the anxiety out of everything and replaced it with excitement.” So do it badly, and you can improve as you go along. I’d like to ask you to think about this. If you start using this motto today, how would your life change?

Olivia explains her first coping technique – do it badly – in a simple, straight forward fashion, and also tells a story about someone who actually tried it. I would have framed this example by stating that there are times when the technique is not appropriate – when doing something badly can be dangerous, to yourself or others. There are times when we should wait until our skill level is adequate. If your story contains recommendations, consider whether a caveat needs to be included.

The second coping strategy is to forgive yourself, and this is very powerful if you use it. People with anxiety think a lot about what they’re doing wrong, their worries, and how bad they’re feeling. Imagine if you had a friend who constantly pointed out everything that you’re doing wrong, and everything that was wrong with your life. You would probably want to get rid of this person right away, wouldn’t you? Well, people with anxiety do this to themselves all day long. They’re not kind to themselves.

So maybe it’s time to start being kinder with ourselves, time to start supporting ourselves. And a way to do this, is to forgive yourself for any mistakes you think you might have made just a few moments ago, to mistakes made in the past. If you had a panic attack and are embarrassed about it, forgive yourself. If you wanted to talk to someone, but couldn’t muster up the courage to do so, don’t worry about it, let it go. Forgive yourself for anything and everything, and this will give you greater compassion towards yourself. You can’t begin to heal until you do this.

And last, but not least, having a purpose and meaning in life is a very important coping mechanism. Whatever we do in life, whatever work we produce, however much money we make, we cannot be fully happy until we know that someone else needs us. That someone else depends on our accomplishments, or on the love that we have to share. It’s not that we need other people’s good words to keep going in life, but if we don’t do something with someone else in mind, then we’re at much higher risk for poor mental health.

The famous neurologist Dr. Victor Frankel said, “For people who think there’s nothing to live for, and nothing more to expect from life, the question is getting these people to realize that life is still expecting something from them.”

Doing something with someone else in mind can carry you through the toughest times. You’ll know the why for your existence and will be able to bear almost any how. Almost any how. So the question is, do you do at least one thing with someone else in mind? This could be volunteering, or it could be sharing this knowledge that you gained today with other people, especially those who need it most, and these are often the people who don’t have money for therapy, and they’re usually the ones with the highest rates of anxiety disorders. Give it to them, share with others, because it can really improve your mental health.

Olivia’s second and third coping resources – regarding self forgiveness and having purpose – are topics that could be the basis of their own talk, but once again, she presents them in an easy and accessible fashion. The audience now has three techniques that they can practice on their own. Should she have also mentioned that anyone experiencing more serious issues should seek out professional help? Are the ideas you present applicable in any situation, or are there limits?

So I would like to conclude with this. Another way you can do something with someone else in mind is finishing work that might benefit future generations. Even if these people will never realize what you’ve done for them, it doesn’t matter, because you will know, and this will make you realize the uniqueness and importance of your life.

One the one hand, I appreciate the message that Olivia ends with – realizing the importance of our life by serving others – that’s very powerful, but it’s basically an extension of her third technique. It’s not a summation of the stories central theme of coping with anxiety. For me, it’s missing that wrap-up.

Thank you.

[Note: all comments inserted into this transcript are my opinions, not those of the speaker, the TED organization, nor anyone else on the planet. In my view, each story is unique, as is every interpretation of that story. The sole purpose of these analytical posts is to inspire a storyteller to become a storylistener, and in doing so, make their stories more impactful.]

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Sangeeta Bhatia: This tiny particle could roam your body to find tumors @ TED Talks Live

November 28, 2020/in Health, Science, TED, TED Talk/by Mark Lovett

TED Talks Live were held at The Town Hall Theater in NYC, in November of 2015. I had the pleasure of attending all six nights to hear speakers present impactful Ideas Worth Spreading. This post is an analysis of a talk by Sangeeta Bhatia that explores new and smaller solutions in the fight against cancer.

Watch Sangeeta’s TED Talk. At one level her talk is rather technical, as it involves the latest, most advanced science, but her story allows the audience to see how the concept works by way of analogy, description, and visuals. If you’re trying to convey a complex idea to a public audience, this is a great example of how that can be accomplished.

Transcript

(my notes in red)

In the space that used to house one transistor, we can now fit one billion. That made it so that a computer the size of an entire room now fits in your pocket. You might say the future is small.

One way to open a technology story is by making a statement directly related to your topic, but another technique is to offer an analogy that describes something completely different, but that shares a common feature. In this case, the feature highlighted is ‘small’, and it will remain a theme throughout her talk.

As an engineer, I’m inspired by this miniaturization revolution in computers. As a physician, I wonder whether we could use it to reduce the number of lives lost due to one of the fastest-growing diseases on Earth: cancer. Now when I say that, what most people hear me say is that we’re working on curing cancer. And we are. But it turns out that there’s an incredible opportunity to save lives through the early detection and prevention of cancer.

The focus pivots from computers to cancer, and Sangeeta lets the audience know that she’ll be exploring how miniaturization may play a role in the detection and prevention of cancer. We see that connection in another way, by saying she’s an ‘engineer’ and a ‘physician’.

If you click on the link to her bio, you’ll see that’s true, but in a short story there is rarely the time to go into any greater detail. And that’s something to remember. Two details change how we think about her, and yet it only took seconds to do so. Brief can still have impact.

Worldwide, over two-thirds of deaths due to cancer are fully preventable using methods that we already have in hand today. Things like vaccination, timely screening and of course, stopping smoking. But even with the best tools and technologies that we have today, some tumors can’t be detected until 10 years after they’ve started growing, when they are 50 million cancer cells strong. What if we had better technologies to detect some of these more deadly cancers sooner, when they could be removed, when they were just getting started?

Sangeeta uses two statistics to describe characteristics of tumors that few people outside the field of medicine would know. In this case, they point to the need for early detection. Before 10 years have passed, and before there are 50 million cancer cells. This type of framing applies to a range of scientific topics, as well as social problems. It follows the logic of, ‘the sooner we know, the better’. Consider whether this technique might apply to your story.

Let me tell you about how miniaturization might get us there. This is a microscope in a typical lab that a pathologist would use for looking at a tissue specimen, like a biopsy or a pap smear. This $7,000 microscope would be used by somebody with years of specialized training to spot cancer cells. This is an image from a colleague of mine at Rice University, Rebecca Richards-Kortum. What she and her team have done is miniaturize that whole microscope into this $10 part, and it fits on the end of an optical fiber. Now what that means is instead of taking a sample from a patient and sending it to the microscope, you can bring the microscope to the patient. And then, instead of requiring a specialist to look at the images, you can train the computer to score normal versus cancerous cells.

Sangeeta comes back to the concept of smaller (miniaturization) as a potential solution. And using a story block about someone else – one of her colleagues – she is able to highlight a solution that improves the detection of cancer. The framing of ‘instead of…’ with ‘you can…’ illustrates the notion that an existing process can be improved by implementing a new idea.

Now this is important, because what they found working in rural communities, is that even when they have a mobile screening van that can go out into the community and perform exams and collect samples and send them to the central hospital for analysis, that days later, women get a call with an abnormal test result and they’re asked to come in. Fully half of them don’t turn up because they can’t afford the trip. With the integrated microscope and computer analysis, Rebecca and her colleagues have been able to create a van that has both a diagnostic setup and a treatment setup. And what that means is that they can do a diagnosis and perform therapy on the spot, so no one is lost to follow up.

Once a new technology (or a solution of any sort) has been developed, can your story talk about how it worked? If you don’t have a story block that validates your idea, then it remains theoretical. Which is sometimes the case. Your story’s narrative can take us to the present moment with a desire to take the next step in the future. Probes have been to Mars, but humans haven’t, so your story may end with your vision of the future.

That’s just one example of how miniaturization can save lives. Now as engineers, we think of this as straight-up miniaturization. You took a big thing and you made it little. But what I told you before about computers was that they transformed our lives when they became small enough for us to take them everywhere. So what is the transformational equivalent like that in medicine? Well, what if you had a detector that was so small that it could circulate in your body, find the tumor all by itself and send a signal to the outside world? It sounds a little bit like science fiction. But actually, nanotechnology allows us to do just that. Nanotechnology allows us to shrink the parts that make up the detector from the width of a human hair, which is 100 microns, to a thousand times smaller, which is 100 nanometers. And that has profound implications.

Having taken the ‘smaller’ idea to one level, Sangeeta takes us to place that, as she admits, ‘sounds a bit like science fiction’. In this case, ‘smaller’ is not just some smaller device, but something so small that we can’t even see it. This is common for science related talks, as processes which occur at the the molecular or nano level, can only be imagined, which means the responsibility falls on the storyteller to bring their audience into that world.

It turns out that materials actually change their properties at the nanoscale. You take a common material like gold, and you grind it into dust, into gold nanoparticles, and it changes from looking gold to looking red. If you take a more exotic material like cadmium selenide — forms a big, black crystal — if you make nanocrystals out of this material and you put it in a liquid, and you shine light on it, they glow. And they glow blue, green, yellow, orange, red, depending only on their size. It’s wild! Can you imagine an object like that in the macro world? It would be like all the denim jeans in your closet are all made of cotton, but they are different colors depending only on their size.

And the way Sangeeta does that, is to compare a property that exists at such a small scale to something that everyone can relate to – their denim jeans – different size equals different color. While jeans are completely different than nanoparticles, we still get the picture.

So as a physician, what’s just as interesting to me is that it’s not just the color of materials that changes at the nanoscale; the way they travel in your body also changes. And this is the kind of observation that we’re going to use to make a better cancer detector.

So let me show you what I mean. This is a blood vessel in the body. Surrounding the blood vessel is a tumor. We’re going to inject nanoparticles into the blood vessel and watch how they travel from the bloodstream into the tumor. Now it turns out that the blood vessels of many tumors are leaky, and so nanoparticles can leak out from the bloodstream into the tumor. Whether they leak out depends on their size. So in this image, the smaller, hundred-nanometer, blue nanoparticles are leaking out, and the larger, 500-nanometer, red nanoparticles are stuck in the bloodstream. So that means as an engineer, depending on how big or small I make a material, I can change where it goes in your body.

In my lab, we recently made a cancer nano detector that is so small that it could travel into the ~~tumor~~ body and look for tumors. We designed it to listen for tumor invasion: the orchestra of chemical signals that tumors need to make to spread. For a tumor to break out of the tissue that it’s born in, it has to make chemicals called enzymes to chew through the scaffolding of tissues. We designed these nanoparticles to be activated by these enzymes. One enzyme can activate a thousand of these chemical reactions in an hour. Now in engineering, we call that one-to-a-thousand ratio a form of amplification, and it makes something ultrasensitive. So we’ve made an ultrasensitive cancer detector.

Once again, we have an example of how the idea becomes real, and we also come back to more of Sangeeta’s personal story, of what is happening in her laboratory. Instead of an ultra-technical description of what the tumor’s enzymes actually do, she uses a visual metaphor of how they ‘chew through’ the ’tissues’. They don’t have teeth, of course, but listeners make the connection and realize that the enzyme has a way to get through, and that’s all the audience needs to understand in order for Sangeeta to continue with the narrative.

OK, but how do I get this activated signal to the outside world, where I can act on it? For this, we’re going to use one more piece of nanoscale biology, and that has to do with the kidney. The kidney is a filter. Its job is to filter out the blood and put waste into the urine. It turns out that what the kidney filters is also dependent on size. So in this image, what you can see is that everything smaller than five nanometers is going from the blood, through the kidney, into the urine, and everything else that’s bigger is retained. OK, so if I make a 100-nanometer cancer detector, I inject it in the bloodstream, it can leak into the tumor where it’s activated by tumor enzymes to release a small signal that is small enough to be filtered out of the kidney and put into the urine, I have a signal in the outside world that I can detect.

The use of visual images is critical here, as they show, in graphic terms, what is happening. If the audience had to figure that out on their own, most of them would be lost. One of the most important uses of static or motion images is to say more than the speaker is saying.

OK, but there’s one more problem. This is a tiny little signal, so how do I detect it? Well, the signal is just a molecule. They’re molecules that we designed as engineers. They’re completely synthetic, and we can design them so they are compatible with our tool of choice. If we want to use a really sensitive, fancy instrument called a mass spectrometer, then we make a molecule with a unique mass. Or maybe we want make something that’s more inexpensive and portable. Then we make molecules that we can trap on paper, like a pregnancy test. In fact, there’s a whole world of paper tests that are becoming available in a field called paper diagnostics.

Alright, where are we going with this? What I’m going to tell you next, as a lifelong researcher, represents a dream of mine. I can’t say that’s it’s a promise; it’s a dream. But I think we all have to have dreams to keep us pushing forward, even — and maybe especially — cancer researchers.

I’m going to tell you what I hope will happen with my technology, that my team and I will put our hearts and souls into making a reality. OK, here goes. I dream that one day, instead of going into an expensive screening facility to get a colonoscopy, or a mammogram, or a pap smear, that you could get a shot, wait an hour, and do a urine test on a paper strip. I imagine that this could even happen without the need for steady electricity, or a medical professional in the room. Maybe they could be far away and connected only by the image on a smartphone.

Now I know this sounds like a dream, but in the lab we already have this working in mice, where it works better than existing methods for the detection of lung, colon and ovarian cancer. And I hope that what this means is that one day we can detect tumors in patients sooner than 10 years after they’ve started growing, in all walks of life, all around the globe, and that this would lead to earlier treatments, and that we could save more lives than we can today, with early detection.

Related to the previous comment about people going to Mars, Sangeeta takes the narrative beyond the laboratory and tells us her ‘what if’ story, which is a type of ‘better future’ story block. Anyone proposing a solution to a problem is, in effect, saying, ‘what if we implemented my solution? if we did, the world could be better for the following reasons’.

Many times speakers will conclude their story with an emphatic statement, along the lines of, ‘the world will be better’. You have to decide whether to frame your statement as a ‘could’ or a ‘will’. Just know that the audience may have their own opinion on the topic.

By using words such as ‘dream’ and ‘hope’, Sangeeta is clear on this point.

Thank you.

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Sam Kass: Want kids to learn well? Feed them well @ TED Talks Live

November 21, 2020/in Education, Health, TED, TED Talk/by Mark Lovett

TED Talks Live were held at The Town Hall Theater in NYC, in November of 2015. I had the pleasure of attending all six nights to hear speakers present impactful Ideas Worth Spreading. This post is an analysis of a talk by Sam Kass about the connection between proper nutrition and success in childhood education.

Watch Sam’s TED Talk. The issues related to proper nutrition and the quality of a child’s education are complex, but Sam provides us with an example of one such solution that has seen positive results. But this talk is also about the choices that storytellers must make in regards to focus and impact.

Transcript

(my notes in red)

I am a chef and a food policy guy, but I come from a whole family of teachers. My sister is a special ed teacher in Chicago. My father just retired after 25 years teaching fifth grade. My aunt and uncle were professors. My cousins all teach. Everybody in my family, basically, teaches except for me.

They taught me that the only way to get the right answers is to ask the right questions. So what are the right questions when it comes to improving the educational outcomes for our children? There’s obviously many important questions, but I think the following is a good place to start: What do we think the connection is between a child’s growing mind and their growing body? What can we expect our kids to learn if their diets are full of sugar and empty of nutrients? What can they possibly learn if their bodies are literally going hungry? And with all the resources that we are pouring into schools, we should stop and ask ourselves: Are we really setting our kids up for success?

We know about chefs, and teachers, but the phrase ‘food policy guy’ is a bit unusual, and that has the audience wondering where his story will take them. Leveraging what he learned from the teachers in his family, Sam asks a series of questions which outline his narrative. Beyond serving as a precursor for his story, the technique of opening a story with questions can also engage the audience and get their cognitive wheels turning.

Now, a few years ago, I was a judge on a cooking competition called “Chopped.” Four chefs compete with mystery ingredients to see who can cook the best dishes. Except for this episode — it was a very special one. Instead of four overzealous chefs trying to break into the limelight — something that I would know nothing about — (Laughter) these chefs were school chefs; you know, the women that you used to call “lunch ladies,” but the ones I insist we call “school chefs.” Now, these women — God bless these women — they spend their day cooking for thousands of kids, breakfast and lunch, with only $2.68 per lunch, with only about a dollar of that actually going to the food. In this episode, the main-course mystery ingredient was quinoa. Now, I know it’s been a long time since most of you have had a school lunch, and we’ve made a lot of progress on nutrition, but quinoa still is not a staple in most school cafeterias.

Many people will have seen Sam on television, but for those that have not, his quick mention of that fact tells us that he’s not just a chef (he told us that in his opening line) but a chef who is good enough to be a judge for a cooking competition. Often times you can provide a single sentence that says a lot about who you are in connection to the story you’re telling.

So this was a challenge. But the dish that I will never forget was cooked by a woman named Cheryl Barbara. Cheryl was the nutrition director at High School in the Community in Connecticut. She cooked this delicious pasta. It was amazing. It was a pappardelle with Italian sausage, kale, Parmesan cheese. It was delicious, like, restaurant-quality good, except — she basically just threw the quinoa, pretty much uncooked, into the dish. It was a strange choice, and it was super crunchy. So I took on the TV accusatory judge thing that you’re supposed to do, and I asked her why she did that.

Cheryl responded, “Well, first, I don’t know what quinoa is.” (Laughter) “But I do know that it’s a Monday, and that in my school, at High School in the Community, I always cook pasta.”

See, Cheryl explained that for many of her kids, there were no meals on the weekends. No meals on Saturday. No meals on Sunday, either. So Cheryl cooked pasta because she wanted to make sure she cooked something she knew her children would eat. Something that would stick to their ribs, she said. Something that would fill them up. Cheryl talked about how, by the time Monday came, her kids’ hunger pangs were so intense that they couldn’t even begin to think about learning. Food was the only thing on their mind. The only thing. And unfortunately, the stats — they tell the same story.

This story block is about someone other than Sam. In this case, it’s someone that he has met and interacted with, so he could tell it from personal experience, but we are basically in the shoes of this other person. Think about the people you have met that could be part of your narrative. Capture those as current or future story blocks. Some speakers have dozens of such stories to draw on.

So, let’s put this into the context of a child. And we’re going to focus on the most important meal of the day, breakfast. Meet Allison. She’s 12 years old, she’s smart as a whip and she wants to be a physicist when she grows up. If Allison goes to a school that serves a nutritious breakfast to all of their kids, here’s what’s going to follow. Her chances of getting a nutritious meal, one with fruit and milk, one lower in sugar and salt, dramatically increase. Allison will have a lower rate of obesity than the average kid. She’ll have to visit the nurse less. She’ll have lower levels of anxiety and depression. She’ll have better behavior. She’ll have better attendance, and she’ll show up on time more often. Why? Well, because there’s a good meal waiting for her at school. Overall, Allison is in much better health than the average school kid.

So what about that kid who doesn’t have a nutritious breakfast waiting for him? Well, meet Tommy. He’s also 12. He’s a wonderful kid. He wants to be a doctor. By the time Tommy is in kindergarten, he’s already underperforming in math. By the time he’s in third grade, he’s got lower math and reading scores. By the time he’s 11, it’s more likely that Tommy will have to have repeated a grade. Research shows that kids who do not have consistent nourishment, particularly at breakfast, have poor cognitive function overall.

Here we have two more stories of other people – both designed to illustrate the connection between educational success and healthy nutrition – with one having a positive outcome, while the other outcome is negative. The use of contrasting stories is a common technique, used to show what happens when one path is taken over the other.

Sometimes these paths are imposed – in this case we’re dealing with children who don’t really have a choice – but in other situations the path is chosen – an adult who chooses to eat too much, or drink too much, or smoke cigarettes. In either case, the audience knows which is the better path, but they also know there are challenges to taking that path. This dilemma sets up the next phase of the story.

So how widespread is this problem? Well, unfortunately, it’s pervasive. Let me give you two stats that seem like they’re on opposite ends of the issue, but are actually two sides of the same coin. On the one hand, one in six Americans are food insecure, including 16 million children — almost 20 percent — are food insecure. In this city alone, in New York City, 474,000 kids under the age of 18 face hunger every year. It’s crazy.

On the other hand, diet and nutrition is the number one cause of preventable death and disease in this country, by far. And fully a third of the kids that we’ve been talking about tonight are on track to have diabetes in their lifetime.

Now, what’s hard to put together but is true is that, many times, these are the same children. So they fill up on the unhealthy and cheap calories that surround them in their communities and that their families can afford. But then by the end of the month, food stamps run out or hours get cut at work, and they don’t have the money to cover the basic cost of food.

Sam offers a statistical story block to demonstrate the magnitude of the problem. It’s very shocking to hear that nearly a half million kids in New York City face hunger every year. Are there statistics that can help support your narrative, that can highlight the importance of your message? You can use static numbers, or present a trend line if the numbers are going up or down.

But I would also like to mention Sam’s use of the phrase ‘diet and nutrition is the number one cause of preventable death and disease in this country, by far’. I found it equally shocking, yet it didn’t ring true for me. I’m not saying it was a false statement, but it seemed to be such a serious claim that it needed an explanation. What are the categories of ‘preventable death and disease’ that he’s talking about? What are the relevant statistics?

The point is, when you’re making a serious claim – about anything – consider whether you need to explain it further, or provide statistics, or quote the source of your claim.

But we should be able to solve this problem, right? We know what the answers are. As part of my work at the White House, we instituted a program that for all schools that had 40 percent more low-income kids, we could serve breakfast and lunch to every kid in that school. For free.

This program has been incredibly successful, because it helped us overcome a very difficult barrier when it came to getting kids a nutritious breakfast. And that was the barrier of stigma. See, schools serve breakfast before school, and it was only available for the poor kids. So everybody knew who was poor and who needed government help.

Now, all kids, no matter how much or how little their parents make, have a lot of pride. So what happened? Well, the schools that have implemented this program saw an increase in math and reading scores by 17.5 percent. 17.5 percent. And research shows that when kids have a consistent, nutritious breakfast, their chances of graduating increase by 20 percent. 20 percent. When we give our kids the nourishment they need, we give them the chance to thrive, both in the classroom and beyond.

The story now pivots from problem to solution, and we get one more slice of information about Sam – that he was working on this project at the White House. If he was to expand this story from its short 12 minute format to keynote length, these few words could become a significant story block of its own. The beauty of story blocks is how they can be expanded or contracted based on the time allowed.

Now, you don’t have to trust me on this, but you should talk to Donna Martin. I love Donna Martin. Donna Martin is the school nutrition director at Burke County in Waynesboro, Georgia. Burke County is one of the poorest districts in the fifth-poorest state in the country, and about 100 percent of Donna’s students live at or below the poverty line. A few years ago, Donna decided to get out ahead of the new standards that were coming, and overhaul her nutrition standards. She improved and added fruit and vegetables and whole grains. She served breakfast in the classroom to all of her kids. And she implemented a dinner program. Why? Well, many of her kids didn’t have dinner when they went home.

So how did they respond? Well, the kids, they loved the food. They loved the better nutrition, and they loved not being hungry. But Donna’s biggest supporter came from an unexpected place. His name was Eric Parker, and he was the head football coach for the Burke County Bears. Now, Coach Parker had coached mediocre teams for years. The Bears often ended in the middle of the pack — a big disappointment in one of the most passionate football states in the Union. But the year Donna changed the menus, the Bears not only won their division, they went on to win the state championship, beating the Peach County Trojans 28-14.

And Coach Parker, he credited that championship to Donna Martin.

This is a fun story block about how the football team improved their performance after the food program was improved, but it feels off topic to me and takes away from what I feel is the more important story of the link between nutrition and education. It’s a stylistic choice, of course, but when you want your story to have the most impact possible, carefully consider what content you will include, and what content to leave out. Especially when you have a very limited time to tell it. Some points that work in a long talk can be cut in a shorter talk.

When we give our kids the basic nourishment, they’re going to thrive. And it’s not just up to the Cheryl Barbaras and the Donna Martins of the world. It’s on all of us. And feeding our kids the basic nutrition is just the starting point. What I’ve laid out is really a model for so many of the most pressing issues that we face.

If we focus on the simple goal of properly nourishing ourselves, we could see a world that is more stable and secure; we could dramatically improve our economic productivity; we could transform our health care and we could go a long way in ensuring that the Earth can provide for generations to come. Food is that place where our collective efforts can have the greatest impact.

I think we would all agree with Sam that proper nutrition is linked to a wide range of global issues, but it’s unusual to begin on one topic – education – then expand it – athletics – and expand it further still – economics and health care. On the one hand, it speaks to how important the topic of nutrition is, but on the other hand, it strays from the opening topic. In the end, such decisions are up to the storyteller. I would simply suggest that you never stray from the intent of maximizing impact.

So we have to ask ourselves: What is the right question? What would happen if we fed ourselves more nutritious, more sustainably grown food? What would be the impact? Cheryl Barbara, Donna Martin, Coach Parker and the Burke County Bears — I think they know the answer.

Thank you guys so very much.

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The Country Doctor on Snap Judgement

May 28, 2020/in Discrimination, Health, Podcast, Storylistening, Truth/by Mark Lovett

America has had problems with discrimination from day one. Look no further than the death toll of Native Americans, often deemed to be heathens, as settlers pushed onward from sea to shining sea. And with the invention of the cotton gin, wealthy landowners sanctified an increase in slavery, economically justifying the practice of kidnapping, shackling, and selling Africans to the highest bidder.

Then we have the egregious treatment of Mexican citizens. You know, the folks who owned a significant chunk of the Western U.S. until they exited south at gunpoint. And let’s not forget about the treatment of immigrants from China, South America and the Middle East. These are not simple histories. In fact, quite the opposite, as there have always been Americans who were welcoming to people of any country, ethnicity or religion. But discrimination has been, and continues to be, a shameful truth in the land of freedom and justice for all.

It was encouraging to see America make progress on this front during the late 60s into the 70s and 80s, but backsliding on the ideal of equality was evident from the 1990s onward. Slowly at first, but rapidly accelerating over the past 3+ years with public displays of hate and prejudice seen in many parts of the country. Displays without remorse of apology.

But all is not lost. Hearts can soften and open with grace whenever people resist stereotyping and instead rely on the power of human connection to speak truth to hate. Whenever we remove the wall of discrimination long enough to forge meaningful relationships, a space for the miraculous appears. A space where healing and justice coexist alongside internal struggle.

Snap Judgement recently broadcast a story that I highly recommend listening to. It was one of those rare podcast episodes that stopped me in my tracks, as I needed to hear the story of Dr. Ayaz Virji until the very end. Give it a listen.

Artwork by Teo Ducot | Snap Judgment | WNYC Studios

When Dr. Ayaz Virji first set foot in Dawson, Minnesota, he didn’t know what to expect. He was a brown Muslim man walking into a predominantly white rural town. But much to his surprise Ayaz and his family fit right in. Dawson quickly became home and his neighbors became like his extended family. Then came the presidential election of 2016.

Dr. Ayaz Virji was aware of the positive impact he could have on a small rural town serving as a clinic medical director and chief of staff. And while the community embraced his family upon their arrival, and he enjoyed working with his patients, an abrupt change in the national political climate upset his view of the world, and his place in it.

The narrative follows Dr. Virji’s journey of self-discovery and reflection, of confrontation and conversation within the town after the 2016 election. As you listen to his story, think about the decisions made along the way, by all parties, but especially by Dr. Virji. How did each decision alter the plot of the story? How would you have reacted?

With my white, middle class background, living a life free from discrimination, it’s hard for me to wear his shoes (or anyone else in similar circumstances), to understand his decisions, to feel the pain and frustration that I clearly hear in his voice. What would I have done?

I continue to struggle with recognizing and dealing with the rifts of hate and discrimination in society, but as all impactful stories do, this podcast has altered my frame of reference, and I now view my own story through a new lens. And hopefully it will also make me a better storylistener.

Image credit: Snap Judgment | WNYC Studios

Nancy López is a senior producer at Snap Judgment. She started in radio in 2006 when she joined Soul Rebel Radio, a collective of novice storytellers in Los Angeles. Since then, she’s worked as a producer for Radio Ambulante and Making Contact. Her stories have been featured on PRI’s The World, KALW in San Francisco, and Radio Bilingue.

The Country Doctor – Season 11 – Episode 18 – Produced by Nancy Lopez, Original score by Renzo Gorrio, Artwork by Teo Ducot – Snap Judgement founded by Glynn Washington.

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