The following information is used for educational purposes only.
Fin de año a toda orquesta
Mensaje para usted amigo lector: Brindemos por un país mejor. Felices fiestas para todos.
Alejandro Borensztein
Antes que nada amigo lector, le propongo que hagamos un minuto de silencio por el fallecimiento del predio del Tiro Federal. Un sentido homenaje a los espacios urbanos caídos en la lucha por la resistencia verde.
En esta parte de la nota nos ponemos todos de pie, colocamos nuestra mano derecha sobre el corazón, y guardamos un respetuoso silencio. No hagamos como en la cancha que a la hora de un recordatorio siempre hay un inadaptado que aprovecha la situación para insultar. Por favor, nada de “Larreta se la come” ni groserías por el estilo.
Tampoco vale que la dirigencia kirchnerista aproveche el momento de recogimiento para hacerse oir y agraviar al Presidente de la República con gritos del tipo “Macri basura, vos sos la dictadura” o “che gorila, che gorila, no te lo decimos más, si la tocan a Cristina (en concurso real con De Vido, Lázaro, Cristóbal, Jose López y otros), que quilombo se va a armar”. Le pido a los dirigentes kirchneristas sin excepción que sean respetuosos. A todos ellos, a los 15.
En realidad, si contamos a Esteche, D’Elía y Boudou serían 18, pero si le restamos lo que ya están en cana, te quedan 11 ó 12 como mucho. Y a juzgar por lo que pasó esta semana, en cualquier momento se agrega una presidiaria más y se quedan con 10. En fin. Silenzio stampa. Silencio piadoso.
A propósito de D’Elía, el jueves publicó un tweet pidiéndole a Dios que Macri se muera. Así como lo lee amigo lector. Posta. Ya no hay dudas que Durán Barba le debe pagar una fortuna a este tipo para que arruine al kirchnerismo.
Ahora si, vamos con la última nota del año. Exactamente, la nota número 400 tras 9 años consecutivos en esta página 2 del diario responsable del 30% de pobreza, la falta de energía y el crecimiento del narcotráfico, entre otros flagelos.
Lo noto preocupado amigo. Un poco desanimado. Se que usted, como mucha otra gente, piensa que este gobierno es medio blandengue, que se queda a mitad de camino, que no hicieron el espamento necesario por la herencia que recibieron de la batucada hotelera y que les falta temple para dar vuelta la decadencia económica.
Déjeme que le muestre otra visión de las cosas. ¿Usted vió como echaron a Isela Costantini? Siendo una de las ejecutivas más importantes de América Latina y la capa de General Motors, la mina dejó todo, se puso al hombro la misión de transformar Aerolíneas en una gran compañía y, sin embargo, de una día para el otro, la echaron como a un perro. No le dieron ni las gracias.
No contentos con eso, un par de días después lo echaron a Prat Gay. ¿Usted vió la cara que tenía Marcos Peña cuando lo anunció en la conferencia de prensa? Él, Marquitos, el que siempre tiene esa imagen de buen muchacho, pacífico, razonable. ¡¡Parecía Robledo Puch a los 20 años!! Irreconocible. Impiadoso. Era Atila hablando frente a las murallas de Constantinopla. ¿No podían esperar una semanita más y dejar que los Compañeros Isela y Alfonso pasaran las fiestas en paz? ¿Con qué ánimo van a brindar esta noche?
Esto demuestra amigo lector que, contrariamente a lo que usted piensa, no son tan tiernitos. Esta gente de Cambiemos será muy espiritual, muy zen, muy cool, muy vegana, muy new age, muy Uritorcos, … pero a la hora de echar a un tipo son unos sanguinarios como no veíamos desde la época de Calígula. No los tiran a los leones porque no quieren que les digan que son más malos que Ex Ella.
Después, cuando se dieron cuenta que se les había ido la mano, lo llamaron a Prat Gay y para disimular lo mimaron un poco, lo dejaron exponer el éxito del blanqueo, le armaron un bolsito, le pidieron un radiotaxi y a otra cosa mariposa. Pero el demonio ya había mostrado su verdadero rostro. A partir de ahora los ministros son los “Veintitrés del Patíbulo” (Aclaración: “Doce del patíbulo”, film de 1967 con Lee Marvin, Charles Bronson, John Cassavetes, Ernest Borgnine, Donald Sutherland y gran elenco. Cuatro nominaciones para el Oscar).
Primeros en la fila del cadalso ya estarían Malcorra y Garavano, entre otros.
Malcorra llegó al gobierno con bombos y platillos, pero luego vino su campaña para presidir las Naciones Unidas, cierta conducta errática con Venezuela, el descuido en la ONU con el tema Milagro Sala, y los desafortunados tweets lamentando la derrota de Hillary. Me parece que Malcorra es a Cambiemos lo que el Ogro Fabbiani a River.
Distinto el caso de Garavano al que injustamente acusan de no haber activado el Consejo de la Magistratura ante tantos jueces cuestionados. Un problema que seguramente se resolverá en cuanto el Compañero Mauri se hagá un ratito y le tome juramento como Ministro de Justicia, así Garavano puede empezar a ejercer el cargo y Angelici puede volver a Boca.
En realidad, la fiereza del gobierno se vio de entrada. Recuerde lo que pasó con la ley de medios.
Años rompiendo las pelotas con Mariotto, el 7D y la mar en coche. Asumió Macri, mandó dos empleados municipales con una escobita, lo barrieron a Sabbatella, lo sacaron en una palita de plástico, cerraron la AFCSA, pusieron un policía de tránsito en la puerta y chau. Al día siguiente, el kirchnerismo duro convocó a un abrazo alrededor de la AFCSA. Fueron Cerrutti y cuatro más. Había más vendedores de garrapiñadas que militantes. Después el Congreso convalidó el DNU y en dos minutos los liquidó. Macri no les tiene piedad. Y eso es lo que más vuelve locos a los dueños de The Kirchner Hotel & Resort for the Liberation. “¡¡Como no nos animamos a entrar con un tanque de guerra a TN y encerrar a Lapegüe y sus amigos en la Isla del Diablo!!!”, deben pensar. Too late my friend.
Ex Ella todavía lo está puteando a Zannini por no haber pensado en meter un par de jueces en la Corte por decreto, como hizo Macri, y aprobar el DNU siendo que tenían mayoría en el Congreso.
Ahora sólo les queda balbucear ñañañas en las redes sociales. Dijo Ex Ella el jueves: “me acusan de encubrir un atentado que ocurrió hace 22 años, lo único que les falta es acusarme de la muerte de Kennedy”. Pequeño error. Nadie la acusa de lo que pasó hace 22 años sino de lo que pasó hace 4. Ni nadie la va a acusar del asesinato de Kennedy, sino del de Nisman.
La reapertura de la causa es un punto para los buenos y una caricia para Iara y Kala Nisman, esas hijas agraviadas vergonzosamente por el gobierno anterior.
Así termina el año amigo lector. Pese a las penurias que siguen sufriendo los más débiles, fue un año mejor. Nunca olvidemos que hoy podríamos estar cortando pan dulce con Scioli, Zannini y Aníbal.
Menos los que gritan que Macri es una dictadura y que pasamos del 4% de pobres al 30%, el resto del país político empuja civilizada y democráticamente, aún con matices, para el mismo lado. Oficialismo, peronismo, renovadores, progresistas, socialistas, sindicatos, organizaciones sociales. Sólo falta que los empresarios piensen un poco más en sus nietos y metan la mano en el bolsillo de una buena vez.
Y que el gobierno acierte un poquito más. Tengamos fe. Dijo James Joyce: “los errores de un hombre son sus portales de descubrimiento” Mensaje para el Presidente: Comprate un auto blindado macho que no ganamos para sustos. Y no me aflojes. Felicidades para vos, Juliana y toda la crianza.
Mensaje para Balcarce: no te distraigas ni les saques el ojo de encima, cualquier cosita ladrá, ok?
Mensaje para usted amigo lector: Brindemos por un país mejor. Felices fiestas para todos.
Fin de temporada.
Fuente:www.clarin.com
In this blog, teachers, students and all those who have some kind of interest in the English language will find useful, interesting, curious and funny things to be used in their classes or for their personal enjoyment.
Saturday, December 31, 2016
SALUDO DE FIN DE AÑO/HAPPY NEW YEAR!GralInt-TED Talks-Kate Adams: 4 larger-than-life lessons from soap operas
The following information is used for educational purposes only.
Filmed September 2016 at TED@UPS
Kate Adams: 4 larger-than-life lessons from soap operas
Soap operas and telenovelas may be (ahem) overdramatic, but as Kate Adams shows us, their exaggerated stories and characters often cast light on the problems of real life. In this sparkling, funny talk, Adams, a former assistant casting director for "As the World Turns," share four lessons for life and business that we can learn from melodramas.
Transcript (English)/ Spanish subtitles available/disponible con subtítulos en Español):
In 1987, Tina Lord found herself in quite the pickle. See, this gold digger made sure she married sweet Cord Roberts just before he inherited millions. But when Cord found out Tina loved his money as much as she loved him, he dumped her. Cord's mother Maria was thrilled until they hooked up again. So Maria hired Max Holden to romance Tina and then made sure Cord didn't find out Tina was pregnant with his baby. So Tina, still married but thinking Cord didn't love her flew to Argentina with Max. Cord finally figured out what was going on and rushed after them, but he was too late. Tina had already been kidnapped, strapped to a raft and sent over a waterfall. She and her baby were presumed dead. Cord was sad for a bit, but then he bounced right back with a supersmart archaeologist named Kate, and they had a gorgeous wedding until Tina, seemingly back from the dead, ran into the church holding a baby. "Stop!" she screamed. "Am I too late? Cord, I've come so far. This is your son."
And that, ladies and gentlemen, is how the soap opera "One Life to Live" introduced a love story that lasted 25 years.
(Laughter)
Now, if you've ever seen a soap opera, you know the stories and the characters can be exaggerated, larger than life, and if you're a fan, you find that exaggeration fun, and if you're not, maybe you find them melodramatic or unsophisticated. Maybe you think watching soap operas is a waste of time, that their bigness means their lessons are small or nonexistent. But I believe the opposite to be true. Soap operas reflect life, just bigger. So there are real life lessons we can learn from soap operas, and those lessons are as big and adventurous as any soap opera storyline.
Now, I've been a fan since I ran home from the bus stop in second grade desperate to catch the end of Luke and Laura's wedding, the biggest moment in "General Hospital" history.
(Applause)
So you can imagine how much I loved my eight years as the assistant casting director on "As the World Turns." My job was watching soap operas, reading soap opera scripts and auditioning actors to be on soap operas. So I know my stuff.
(Laughter)
And yes, soap operas are larger than life, drama on a grand scale, but our lives can be filled with as much intensity, and the stakes can feel just as dramatic. We cycle through tragedy and joy just like these characters. We cross thresholds, fight demons and find salvation unexpectedly, and we do it again and again and again, but just like soaps, we can flip the script, which means we can learn from these characters that move like bumblebees, looping and swerving through life. And we can use those lessons to craft our own life stories. Soap operas teach us to push away doubt and believe in our capacity for bravery, vulnerability, adaptability and resilience. And most importantly, they show us it's never too late to change your story.
So with that, let's start with soap opera lesson one: surrender is not an option.
(Laughter)
"All My Children"'s Erica Kane was daytime's version of Scarlett O'Hara, a hyperbolically self-important princess who deep down was scrappy and daring. Now, in her 41 years on TV, perhaps Erica's most famous scene is her alone in the woods suddenly face to face with a grizzly bear. She screamed at the bear, "You may not do this! Do you understand me? You may not come near me! I am Erica Kane and you are a filthy beast!"
(Laughter)
And of course the bear left, so what that teaches us is obstacles are to be expected and we can choose to surrender or we can stand and fight.
Pandora's Tim Westergren knows this better than most. You might even call him the Erica Kane of Silicon Valley. Tim and his cofounders launched the company with two million dollars in funding. They were out of cash the next year. Now, lots of companies fold at that point, but Tim chose to fight. He maxed out 11 credit cards and racked up six figures in personal debt and it still wasn't enough. So every two weeks for two years on payday he stood in front of his employees and he asked them to sacrifice their salaries, and it worked. More than 50 people deferred two million dollars, and now, more than a decade later, Pandora is worth billions. When you believe that there is a way around or through whatever is in front of you, that surrender is not an option, you can overcome enormous obstacles.
Which brings us to soap opera lesson two: sacrifice your ego and drop the superiority complex.
Now, this is scary. It's an acknowledgment of need or fallibility. Maybe it's even an admission that we're not as special as we might like to think. Stephanie Forrester of "The Bold and the Beautiful" thought she was pretty darn special. She thought she was so special, she didn't need to mix with the riffraff from the valley, and she made sure valley girl Brooke knew it. But after nearly 25 years of epic fighting, Stephanie got sick and let Brooke in. They made amends, archenemies became soul mates and Stephanie died in Brooke's arms, and here's our takeaway. Drop your ego. Life is not about you. It's about us, and our ability to experience joy and love and to improve our reality comes only when we make ourselves vulnerable and we accept responsibility for our actions and our inactions, kind of like Howard Schultz, the CEO of Starbucks.
Now, after a great run as CEO, Howard stepped down in 2000, and Starbucks quickly overextended itself and stock prices fell. Howard rejoined the team in 2008, and one of the first things he did was apologize to all 180,000 employees. He apologized. And then he asked for help, honesty, and ideas in return. And now, Starbucks has more than doubled its net revenue since Howard came back. So sacrifice your desire to be right or safe all the time. It's not helping anyone, least of all you. Sacrifice your ego.
Soap opera lesson three: evolution is real. You're not meant to be static characters. On television, static equals boring and boring equals fired. Characters are supposed to grow and change. Now, on TV, those dynamic changes can make for some rough transitions, particularly when a character is played by one person yesterday and played by someone new today. Recasting happens all the time on soaps. Over the last 20 years, four different actors have played the same key role of Carly Benson on "General Hospital." Each new face triggered a change in the character's life and personality. Now, there was always an essential nugget of Carly in there, but the character and the story adapted to whomever was playing her.
And here's what that means for us. While we may not swap faces in our own lives, we can evolve too. We can choose to draw a circle around our feet and stay in that spot, or we can open ourselves to opportunities like Carly, who went from nursing student to hotel owner, or like Julia Child.
Julia was a World War II spy, and when the war ended, she got married, moved to France, and decided to give culinary school a shot. Julia, her books and her TV shows revolutionized the way America cooks.
We all have the power to initiate change in our lives, to evolve and adapt. We make the choice, but sometimes life chooses for us, and we don't get a heads up. Surprise slams us in the face. You're flat on the ground, the air is gone, and you need resuscitation.
So thank goodness for soap opera lesson four: resurrection is possible.
(Laughter)
(Applause)
In 1983, "Days of Our Lives"' Stefano DiMera died of a stroke, but not really, because in 1984 he died when his car plunged into the harbor, and yet he was back in 1985 with a brain tumor.
(Laughter)
But before the tumor could kill him, Marlena shot him, and he tumbled off a catwalk to his death. And so it went for 30 years.
(Laughter)
Even when we saw the body, we knew better. He's called the Phoenix for a reason. And here's what that means for us. As long as the show is still on the air, or you're still breathing, nothing is permanent. Resurrection is possible.
Now, of course, just like life, soap operas do ultimately meet the big finale. CBS canceled my show, "As The World Turns," in December 2009, and we shot our final episode in June 2010. It was six months of dying and I rode that train right into the mountain. And even though we were in the middle of a huge recession and millions of people were struggling to find work, I somehow thought everything would be OK. So I packed up the kids and the Brooklyn apartment, and we moved in with my in-laws in Alabama.
(Laughter)
Three months later, nothing was OK. That was when I watched the final episode air, and I realized the show was not the only fatality. I was one too. I was unemployed and living on the second floor of my in-laws' home, and that's enough to make anyone feel dead inside.
(Laughter)
But I knew my story wasn't over, that it couldn't be over. I just had to tap into everything I had ever learned about soap operas. I had to be brave like Erica and refuse to surrender, so every day, I made a decision to fight. I had to be vulnerable like Stephanie and sacrifice my ego. I had to ask for help a lot of times across many states. I had to be adaptable like Carly and evolve my skills, my mindset, and my circumstances, and then I had to be resilient, like Stefano, and resurrect myself and my career like a phoenix from the ashes.
Eventually I got an interview. After 15 years in news and entertainment, nine months of unemployment and this one interview, I had an offer for an entry level job. I was 37 years old and I was back from the dead.
We will all experience what looks like an ending, and we can choose to make it a beginning. Kind of like Tina, who miraculously survived that waterfall, and because I hate to leave a cliffhanger hanging, Tina and Cord did get divorced, but they got remarried three times before the show went off the air in 2012.
So remember, as long as there is breath in your body, it's never too late to change your story.
Thank you.
(Applause)
Hola, familia, amigos, conocidos, colegas, lectores, y a todos aquellos que en este último
día del año y a pocas horas del comienzo del 2017 se están preparando para este Nuevo
Año que ya está llegando.
Que está llegando aunque no lo invitemos o llamemos; el tiempo es así, rebelde e
independiente, se mueve, pasa y se va sin que podamos tener mayor intervención en ello.
Pero Kate Adams en esta interesante charla,(me pareció apropiada y oportuna para este
momento) nos propone cuatro lecciones que bien podríamos considerar para nuestra
propia vida, especialmente cuando -o al menos podemos usarlas como excusa- se termina
un año y empieza uno nuevo.
Aprovechemos también nosotros, entonces, a poner en práctica alguna de estas
enseñanzas o tips, si lo prefieren tomar o aplicar de otro modo.
Kate nos dice inicialmente que "Nunca es tarde para cambiar tu historia".
Aquí las lecciones que nos sugiere:
*Lección 1: RENDIRSE NO ES UNA OPCIÓN.
*Lección 2: SACRIFICA TU EGO Y DEJA DE LADO TU COMPLEJO DE
SUPERIORIDAD.
*Lección 3: LA EVOLUCIÓN ES REAL.
*Lección 4: LA RESURRECCIÓN ES POSIBLE.
Todos podemos convertirnos, y resurgir de nuestras cenizas como el ave Fénix
como nos cuenta Kate.
Por eso aprovechemos este inicio del nuevo año para hacer nuestros propios ajustes,
cambios, renovaciones, y correcciones, y seguramente experimentemos que nosotros
también tenemos la posibilidad de cambiar nuestra historia y renacer de nuestras cenizas
como el Ave Fénix.
A todos Uds. como siempre les dejo mis Mejores Deseos de un excelente AÑO NUEVO
& HAPPY NEW YEAR! Les envío a todos un beso grande y toda la fuerza para
reconvertirse.
C.M. (The Phoenix)
Fuente: Google Images/Palabras de la autora del blog C.M.,
inspiradas en la charla de Kate Adams.
Filmed September 2016 at TED@UPS
Kate Adams: 4 larger-than-life lessons from soap operas
Soap operas and telenovelas may be (ahem) overdramatic, but as Kate Adams shows us, their exaggerated stories and characters often cast light on the problems of real life. In this sparkling, funny talk, Adams, a former assistant casting director for "As the World Turns," share four lessons for life and business that we can learn from melodramas.
Transcript (English)/ Spanish subtitles available/disponible con subtítulos en Español):
In 1987, Tina Lord found herself in quite the pickle. See, this gold digger made sure she married sweet Cord Roberts just before he inherited millions. But when Cord found out Tina loved his money as much as she loved him, he dumped her. Cord's mother Maria was thrilled until they hooked up again. So Maria hired Max Holden to romance Tina and then made sure Cord didn't find out Tina was pregnant with his baby. So Tina, still married but thinking Cord didn't love her flew to Argentina with Max. Cord finally figured out what was going on and rushed after them, but he was too late. Tina had already been kidnapped, strapped to a raft and sent over a waterfall. She and her baby were presumed dead. Cord was sad for a bit, but then he bounced right back with a supersmart archaeologist named Kate, and they had a gorgeous wedding until Tina, seemingly back from the dead, ran into the church holding a baby. "Stop!" she screamed. "Am I too late? Cord, I've come so far. This is your son."
And that, ladies and gentlemen, is how the soap opera "One Life to Live" introduced a love story that lasted 25 years.
(Laughter)
Now, if you've ever seen a soap opera, you know the stories and the characters can be exaggerated, larger than life, and if you're a fan, you find that exaggeration fun, and if you're not, maybe you find them melodramatic or unsophisticated. Maybe you think watching soap operas is a waste of time, that their bigness means their lessons are small or nonexistent. But I believe the opposite to be true. Soap operas reflect life, just bigger. So there are real life lessons we can learn from soap operas, and those lessons are as big and adventurous as any soap opera storyline.
Now, I've been a fan since I ran home from the bus stop in second grade desperate to catch the end of Luke and Laura's wedding, the biggest moment in "General Hospital" history.
(Applause)
So you can imagine how much I loved my eight years as the assistant casting director on "As the World Turns." My job was watching soap operas, reading soap opera scripts and auditioning actors to be on soap operas. So I know my stuff.
(Laughter)
And yes, soap operas are larger than life, drama on a grand scale, but our lives can be filled with as much intensity, and the stakes can feel just as dramatic. We cycle through tragedy and joy just like these characters. We cross thresholds, fight demons and find salvation unexpectedly, and we do it again and again and again, but just like soaps, we can flip the script, which means we can learn from these characters that move like bumblebees, looping and swerving through life. And we can use those lessons to craft our own life stories. Soap operas teach us to push away doubt and believe in our capacity for bravery, vulnerability, adaptability and resilience. And most importantly, they show us it's never too late to change your story.
So with that, let's start with soap opera lesson one: surrender is not an option.
(Laughter)
"All My Children"'s Erica Kane was daytime's version of Scarlett O'Hara, a hyperbolically self-important princess who deep down was scrappy and daring. Now, in her 41 years on TV, perhaps Erica's most famous scene is her alone in the woods suddenly face to face with a grizzly bear. She screamed at the bear, "You may not do this! Do you understand me? You may not come near me! I am Erica Kane and you are a filthy beast!"
(Laughter)
And of course the bear left, so what that teaches us is obstacles are to be expected and we can choose to surrender or we can stand and fight.
Pandora's Tim Westergren knows this better than most. You might even call him the Erica Kane of Silicon Valley. Tim and his cofounders launched the company with two million dollars in funding. They were out of cash the next year. Now, lots of companies fold at that point, but Tim chose to fight. He maxed out 11 credit cards and racked up six figures in personal debt and it still wasn't enough. So every two weeks for two years on payday he stood in front of his employees and he asked them to sacrifice their salaries, and it worked. More than 50 people deferred two million dollars, and now, more than a decade later, Pandora is worth billions. When you believe that there is a way around or through whatever is in front of you, that surrender is not an option, you can overcome enormous obstacles.
Which brings us to soap opera lesson two: sacrifice your ego and drop the superiority complex.
Now, this is scary. It's an acknowledgment of need or fallibility. Maybe it's even an admission that we're not as special as we might like to think. Stephanie Forrester of "The Bold and the Beautiful" thought she was pretty darn special. She thought she was so special, she didn't need to mix with the riffraff from the valley, and she made sure valley girl Brooke knew it. But after nearly 25 years of epic fighting, Stephanie got sick and let Brooke in. They made amends, archenemies became soul mates and Stephanie died in Brooke's arms, and here's our takeaway. Drop your ego. Life is not about you. It's about us, and our ability to experience joy and love and to improve our reality comes only when we make ourselves vulnerable and we accept responsibility for our actions and our inactions, kind of like Howard Schultz, the CEO of Starbucks.
Now, after a great run as CEO, Howard stepped down in 2000, and Starbucks quickly overextended itself and stock prices fell. Howard rejoined the team in 2008, and one of the first things he did was apologize to all 180,000 employees. He apologized. And then he asked for help, honesty, and ideas in return. And now, Starbucks has more than doubled its net revenue since Howard came back. So sacrifice your desire to be right or safe all the time. It's not helping anyone, least of all you. Sacrifice your ego.
Soap opera lesson three: evolution is real. You're not meant to be static characters. On television, static equals boring and boring equals fired. Characters are supposed to grow and change. Now, on TV, those dynamic changes can make for some rough transitions, particularly when a character is played by one person yesterday and played by someone new today. Recasting happens all the time on soaps. Over the last 20 years, four different actors have played the same key role of Carly Benson on "General Hospital." Each new face triggered a change in the character's life and personality. Now, there was always an essential nugget of Carly in there, but the character and the story adapted to whomever was playing her.
And here's what that means for us. While we may not swap faces in our own lives, we can evolve too. We can choose to draw a circle around our feet and stay in that spot, or we can open ourselves to opportunities like Carly, who went from nursing student to hotel owner, or like Julia Child.
Julia was a World War II spy, and when the war ended, she got married, moved to France, and decided to give culinary school a shot. Julia, her books and her TV shows revolutionized the way America cooks.
We all have the power to initiate change in our lives, to evolve and adapt. We make the choice, but sometimes life chooses for us, and we don't get a heads up. Surprise slams us in the face. You're flat on the ground, the air is gone, and you need resuscitation.
So thank goodness for soap opera lesson four: resurrection is possible.
(Laughter)
(Applause)
In 1983, "Days of Our Lives"' Stefano DiMera died of a stroke, but not really, because in 1984 he died when his car plunged into the harbor, and yet he was back in 1985 with a brain tumor.
(Laughter)
But before the tumor could kill him, Marlena shot him, and he tumbled off a catwalk to his death. And so it went for 30 years.
(Laughter)
Even when we saw the body, we knew better. He's called the Phoenix for a reason. And here's what that means for us. As long as the show is still on the air, or you're still breathing, nothing is permanent. Resurrection is possible.
Now, of course, just like life, soap operas do ultimately meet the big finale. CBS canceled my show, "As The World Turns," in December 2009, and we shot our final episode in June 2010. It was six months of dying and I rode that train right into the mountain. And even though we were in the middle of a huge recession and millions of people were struggling to find work, I somehow thought everything would be OK. So I packed up the kids and the Brooklyn apartment, and we moved in with my in-laws in Alabama.
(Laughter)
Three months later, nothing was OK. That was when I watched the final episode air, and I realized the show was not the only fatality. I was one too. I was unemployed and living on the second floor of my in-laws' home, and that's enough to make anyone feel dead inside.
(Laughter)
But I knew my story wasn't over, that it couldn't be over. I just had to tap into everything I had ever learned about soap operas. I had to be brave like Erica and refuse to surrender, so every day, I made a decision to fight. I had to be vulnerable like Stephanie and sacrifice my ego. I had to ask for help a lot of times across many states. I had to be adaptable like Carly and evolve my skills, my mindset, and my circumstances, and then I had to be resilient, like Stefano, and resurrect myself and my career like a phoenix from the ashes.
Eventually I got an interview. After 15 years in news and entertainment, nine months of unemployment and this one interview, I had an offer for an entry level job. I was 37 years old and I was back from the dead.
We will all experience what looks like an ending, and we can choose to make it a beginning. Kind of like Tina, who miraculously survived that waterfall, and because I hate to leave a cliffhanger hanging, Tina and Cord did get divorced, but they got remarried three times before the show went off the air in 2012.
So remember, as long as there is breath in your body, it's never too late to change your story.
Thank you.
(Applause)
Hola, familia, amigos, conocidos, colegas, lectores, y a todos aquellos que en este último
día del año y a pocas horas del comienzo del 2017 se están preparando para este Nuevo
Año que ya está llegando.
Que está llegando aunque no lo invitemos o llamemos; el tiempo es así, rebelde e
independiente, se mueve, pasa y se va sin que podamos tener mayor intervención en ello.
Pero Kate Adams en esta interesante charla,(me pareció apropiada y oportuna para este
momento) nos propone cuatro lecciones que bien podríamos considerar para nuestra
propia vida, especialmente cuando -o al menos podemos usarlas como excusa- se termina
un año y empieza uno nuevo.
Aprovechemos también nosotros, entonces, a poner en práctica alguna de estas
enseñanzas o tips, si lo prefieren tomar o aplicar de otro modo.
Kate nos dice inicialmente que "Nunca es tarde para cambiar tu historia".
Aquí las lecciones que nos sugiere:
*Lección 1: RENDIRSE NO ES UNA OPCIÓN.
*Lección 2: SACRIFICA TU EGO Y DEJA DE LADO TU COMPLEJO DE
SUPERIORIDAD.
*Lección 3: LA EVOLUCIÓN ES REAL.
*Lección 4: LA RESURRECCIÓN ES POSIBLE.
Todos podemos convertirnos, y resurgir de nuestras cenizas como el ave Fénix
como nos cuenta Kate.
Por eso aprovechemos este inicio del nuevo año para hacer nuestros propios ajustes,
cambios, renovaciones, y correcciones, y seguramente experimentemos que nosotros
también tenemos la posibilidad de cambiar nuestra historia y renacer de nuestras cenizas
como el Ave Fénix.
A todos Uds. como siempre les dejo mis Mejores Deseos de un excelente AÑO NUEVO
& HAPPY NEW YEAR! Les envío a todos un beso grande y toda la fuerza para
reconvertirse.
C.M. (The Phoenix)
Fuente: Google Images/Palabras de la autora del blog C.M.,
inspiradas en la charla de Kate Adams.
Friday, December 30, 2016
JUS/GralInt-Luces y sombras en el balance de la Justicia
The following information is used for educational purposes only.
Luces y sombras en el balance de la Justicia
El avance en la independencia judicial debe profundizarse removiendo a aquellos jueces que han dado sobradas muestras de parcialidad
30 DE DICIEMBRE DE 2016
Al pasar revista y analizar las relaciones del gobierno de Mauricio Macri con la Justicia, surge un saldo positivo cuando se contrapone el año transcurrido con los 12 años del kirchnerismo, caracterizados por las fuertes presiones sobre jueces y fiscales en procura de subordinar al Poder Judicial a los designios del oficialismo de entonces.
El mayor respeto por la independencia judicial que rige en la actualidad es un rasgo saliente en este balance, que, no obstante, exhibe también fuertes déficits y la necesidad de corregir más de un rumbo. Otro factor positivo ha sido el reconocimiento de la necesidad de llevar a cabo en el futuro un programa de reforma judicial integral, denominado programa Justicia 2020.
El año comenzó con un serio traspié de Cambiemos en aquello que, sin embargo, resultó uno de sus mayores aciertos en relación con la Justicia. Ocurrió cuando el Poder Ejecutivo intentó designar por decreto y "en comisión" a Carlos Rosenkrantz y Horacio Rosatti como jueces de la Corte Suprema de Justicia. El problema no radicaba en los candidatos, sino en las formas. Luego de las lógicas críticas, el Gobierno optó por enviar al Senado la propuesta de ambos candidatos, quienes finalmente se integraron al máximo tribunal.
Así como también hay que elogiar la prudencia y el buen criterio del ministro de Justicia, Germán Garavano, es preciso reconocer, en cambio, que no contribuyen a la transparencia las intervenciones de presuntos asesores o "gestores" del Presidente ante los tribunales, como Fabián "Pepín" Rodríguez Simón y el empresario del juego y presidente de Boca Daniel Angelici. De ellos, es Angelici quien ha generado los mayores cuestionamientos, comenzando por los de la diputada oficialista Elisa Carrió. Recientemente, Angelici se vio seriamente comprometido por una escucha telefónica en la que el jefe de la barra brava de Boca, Rafael Di Zeo, aseguraba que tenía con él un pacto "a muerte", por el cual -según manifestó- Angelici "nos banca y nosotros lo vamos a bancar". Angelici dista de ser la persona indicada para oficiar de puente con los tribunales, y a medida que transcurre el tiempo se va convirtiendo en un lastre político para el Presidente.
Otro hecho negativo fue el frustrado intento de lograr el desplazamiento de Alejandra Gils Carbó, la titular abiertamente kirchnerista de la Procuración General de la Nación. Más grave que el fracaso fue su alto costo, pues el oficialismo procuró acotarle el poder y el mandato mediante un proyecto de ley sospechado de inconstitucional, y Gils Carbó terminó fortalecida.
También debe computarse entre los grandes desaciertos judiciales la llamativa cortesía de Mauricio Macri con el escandaloso juez federal Norberto Oyarbide. Acorralado por un juicio político, y tras fracasar en su intento mercenario de operar para el Gobierno, el magistrado no tuvo más remedio que presentar su renuncia al Presidente, pero éste, en vez de rechazarla para que continuara su marcha el juicio político que muy probablemente desplazaría a Oyarbide, la aceptó, permitiéndole de esa manera gozar sin inconvenientes de su jubilación.
En el año transcurrido quedó de manifiesto el sometimiento o el servilismo de varios jueces y fiscales federales ante el gobierno de turno. Los mismos que durante años mantuvieron en letargo importantes investigaciones sobre graves hechos de corrupción demostraron tras las elecciones un repentino frenesí investigativo, que en algunos casos en cuanto se alejaron las cámaras de televisión pareció aquietarse nuevamente.
Llama la atención, también, que avancen causas contra Cristina Kirchner, como la del dólar futuro, en la que el aspecto probatorio es bastante discutible, y no aquellas, como Hotesur, que revisten mucha mayor gravedad y donde las pruebas hace tiempo que se encuentran en el sumario. En cambio, hay que destacar la decisión de la Sala I de la Cámara de Casación al ordenar que se investigue la denuncia del fiscal Alberto Nisman contra Cristina Kirchner por presunto encubrimiento en la causa AMIA.
Urge limpiar el fuero federal de jueces cómplices o ineptos. La demora en hacerlo se le achacará al Gobierno, si bien hay que reconocer que la principal responsabilidad es del Consejo de la Magistratura, donde es preciso que avancen las investigaciones al camarista Eduardo Freiler y al juez federal Daniel Rafecas.
Llenar las numerosas vacantes también es responsabilidad del Consejo de la Magistratura, y no se trata sólo de jueces, sino de camaristas. En efecto, hay vacantes en las cámaras de Casación Penal, Federal Penal, en lo Contencioso Administrativo y Nacional Electoral.
En lo que hace al frente interno, hay algunas causas cuyo avance puede afectar al Gobierno. Por ejemplo, el sumario a la vicepresidenta Gabriela Michetti por el origen del dinero robado en su domicilio el día en que ganó el ballottage, en el cual también se investiga a varias fundaciones de Pro. Le siguen el de los Panamá Papers y el que se abrió por haber autorizado mediante un decreto la inclusión en el blanqueo de capitales de los familiares de funcionarios.
Puesto que es innegable la degradación de la justicia argentina, lo que haga o deje de hacer en esta materia fundamental será una de las varas para evaluar la gestión de Mauricio Macri.
Fuente:www.lanacion.com.ar
Luces y sombras en el balance de la Justicia
El avance en la independencia judicial debe profundizarse removiendo a aquellos jueces que han dado sobradas muestras de parcialidad
30 DE DICIEMBRE DE 2016
Al pasar revista y analizar las relaciones del gobierno de Mauricio Macri con la Justicia, surge un saldo positivo cuando se contrapone el año transcurrido con los 12 años del kirchnerismo, caracterizados por las fuertes presiones sobre jueces y fiscales en procura de subordinar al Poder Judicial a los designios del oficialismo de entonces.
El mayor respeto por la independencia judicial que rige en la actualidad es un rasgo saliente en este balance, que, no obstante, exhibe también fuertes déficits y la necesidad de corregir más de un rumbo. Otro factor positivo ha sido el reconocimiento de la necesidad de llevar a cabo en el futuro un programa de reforma judicial integral, denominado programa Justicia 2020.
El año comenzó con un serio traspié de Cambiemos en aquello que, sin embargo, resultó uno de sus mayores aciertos en relación con la Justicia. Ocurrió cuando el Poder Ejecutivo intentó designar por decreto y "en comisión" a Carlos Rosenkrantz y Horacio Rosatti como jueces de la Corte Suprema de Justicia. El problema no radicaba en los candidatos, sino en las formas. Luego de las lógicas críticas, el Gobierno optó por enviar al Senado la propuesta de ambos candidatos, quienes finalmente se integraron al máximo tribunal.
Así como también hay que elogiar la prudencia y el buen criterio del ministro de Justicia, Germán Garavano, es preciso reconocer, en cambio, que no contribuyen a la transparencia las intervenciones de presuntos asesores o "gestores" del Presidente ante los tribunales, como Fabián "Pepín" Rodríguez Simón y el empresario del juego y presidente de Boca Daniel Angelici. De ellos, es Angelici quien ha generado los mayores cuestionamientos, comenzando por los de la diputada oficialista Elisa Carrió. Recientemente, Angelici se vio seriamente comprometido por una escucha telefónica en la que el jefe de la barra brava de Boca, Rafael Di Zeo, aseguraba que tenía con él un pacto "a muerte", por el cual -según manifestó- Angelici "nos banca y nosotros lo vamos a bancar". Angelici dista de ser la persona indicada para oficiar de puente con los tribunales, y a medida que transcurre el tiempo se va convirtiendo en un lastre político para el Presidente.
Otro hecho negativo fue el frustrado intento de lograr el desplazamiento de Alejandra Gils Carbó, la titular abiertamente kirchnerista de la Procuración General de la Nación. Más grave que el fracaso fue su alto costo, pues el oficialismo procuró acotarle el poder y el mandato mediante un proyecto de ley sospechado de inconstitucional, y Gils Carbó terminó fortalecida.
También debe computarse entre los grandes desaciertos judiciales la llamativa cortesía de Mauricio Macri con el escandaloso juez federal Norberto Oyarbide. Acorralado por un juicio político, y tras fracasar en su intento mercenario de operar para el Gobierno, el magistrado no tuvo más remedio que presentar su renuncia al Presidente, pero éste, en vez de rechazarla para que continuara su marcha el juicio político que muy probablemente desplazaría a Oyarbide, la aceptó, permitiéndole de esa manera gozar sin inconvenientes de su jubilación.
En el año transcurrido quedó de manifiesto el sometimiento o el servilismo de varios jueces y fiscales federales ante el gobierno de turno. Los mismos que durante años mantuvieron en letargo importantes investigaciones sobre graves hechos de corrupción demostraron tras las elecciones un repentino frenesí investigativo, que en algunos casos en cuanto se alejaron las cámaras de televisión pareció aquietarse nuevamente.
Llama la atención, también, que avancen causas contra Cristina Kirchner, como la del dólar futuro, en la que el aspecto probatorio es bastante discutible, y no aquellas, como Hotesur, que revisten mucha mayor gravedad y donde las pruebas hace tiempo que se encuentran en el sumario. En cambio, hay que destacar la decisión de la Sala I de la Cámara de Casación al ordenar que se investigue la denuncia del fiscal Alberto Nisman contra Cristina Kirchner por presunto encubrimiento en la causa AMIA.
Urge limpiar el fuero federal de jueces cómplices o ineptos. La demora en hacerlo se le achacará al Gobierno, si bien hay que reconocer que la principal responsabilidad es del Consejo de la Magistratura, donde es preciso que avancen las investigaciones al camarista Eduardo Freiler y al juez federal Daniel Rafecas.
Llenar las numerosas vacantes también es responsabilidad del Consejo de la Magistratura, y no se trata sólo de jueces, sino de camaristas. En efecto, hay vacantes en las cámaras de Casación Penal, Federal Penal, en lo Contencioso Administrativo y Nacional Electoral.
En lo que hace al frente interno, hay algunas causas cuyo avance puede afectar al Gobierno. Por ejemplo, el sumario a la vicepresidenta Gabriela Michetti por el origen del dinero robado en su domicilio el día en que ganó el ballottage, en el cual también se investiga a varias fundaciones de Pro. Le siguen el de los Panamá Papers y el que se abrió por haber autorizado mediante un decreto la inclusión en el blanqueo de capitales de los familiares de funcionarios.
Puesto que es innegable la degradación de la justicia argentina, lo que haga o deje de hacer en esta materia fundamental será una de las varas para evaluar la gestión de Mauricio Macri.
Fuente:www.lanacion.com.ar
BUS/GralInt-Ideas para encarar el nuevo año y compartir con los demás
The following information is used for educational purposes only.
Ideas para encarar el nuevo año y compartir con los demás
Alcanzar objetivos y derribar obstáculos son algunos de los propósitos que surgen de cara al 2017; la coach Andrea Churba aborda estos temas en su ebook gratuito Business Therapy
29 DE DICIEMBRE DE 2016
Business Therapy, el ebook de regalo y para regalar
La coach Andrea Churba decidió, después de más de diez años de trabajar con PNL (programación neurolingüística), integrar su formación en terapia sistémica y ontología del lenguaje y crear su propio método: Business Therapy. Con el mismo nombre sacó un ebook pensado especialmente para cerrar el año. El libro electrónico de Churba es para regalar ya que se puede descargar, pero también enviar como mail o mensaje de Facebook o Whatsapp.
Business Therapy consiste en que cada empleado de una empresa, sin importar su rol, pueda conocer que él es activo en la cultura laboral y sus resultados, y no simplemente una víctima de lo que sucede en la empresa. De este modo, cada trabajador puede recuperar su poder de acción y convertirse en el motor de su liderazgo personal y profesional.
El ebook aborda en sus 54 páginas estas cuestiones y busca acercar a los empleados las herramientas para superar obstáculos y alcanzar metas. Además ofrece ejercicios que ayudan a elaborar autodiagnósticos y planificar e implementar los cambios buscados.
El desafío de liderar a quienes no pueden o no quieren sumarse a la transformación, poder ser personas más empáticas, encauzar la mirada del equipo de trabajo más allá de la bruma del presente hacia la necesidad y los beneficios del cambio, son algunas de las cuestiones que aborda Business Therapy. También intenta ayudar a que las personas puedan convertirse en seres más perspicaces para detectar alertas, leer el contexto y liderar, ir hacia la mejora continua y la capacidad de innovar, conocer qué quiere decir ser menos operativo y más estratégico, surfear los cambios o enraizar lo logrado y sostenerlo en el tiempo.
Accedé al libro aquí.
Fuente: www.lanacion.com.ar
Ideas para encarar el nuevo año y compartir con los demás
Alcanzar objetivos y derribar obstáculos son algunos de los propósitos que surgen de cara al 2017; la coach Andrea Churba aborda estos temas en su ebook gratuito Business Therapy
29 DE DICIEMBRE DE 2016
Business Therapy, el ebook de regalo y para regalar
La coach Andrea Churba decidió, después de más de diez años de trabajar con PNL (programación neurolingüística), integrar su formación en terapia sistémica y ontología del lenguaje y crear su propio método: Business Therapy. Con el mismo nombre sacó un ebook pensado especialmente para cerrar el año. El libro electrónico de Churba es para regalar ya que se puede descargar, pero también enviar como mail o mensaje de Facebook o Whatsapp.
Business Therapy consiste en que cada empleado de una empresa, sin importar su rol, pueda conocer que él es activo en la cultura laboral y sus resultados, y no simplemente una víctima de lo que sucede en la empresa. De este modo, cada trabajador puede recuperar su poder de acción y convertirse en el motor de su liderazgo personal y profesional.
El ebook aborda en sus 54 páginas estas cuestiones y busca acercar a los empleados las herramientas para superar obstáculos y alcanzar metas. Además ofrece ejercicios que ayudan a elaborar autodiagnósticos y planificar e implementar los cambios buscados.
El desafío de liderar a quienes no pueden o no quieren sumarse a la transformación, poder ser personas más empáticas, encauzar la mirada del equipo de trabajo más allá de la bruma del presente hacia la necesidad y los beneficios del cambio, son algunas de las cuestiones que aborda Business Therapy. También intenta ayudar a que las personas puedan convertirse en seres más perspicaces para detectar alertas, leer el contexto y liderar, ir hacia la mejora continua y la capacidad de innovar, conocer qué quiere decir ser menos operativo y más estratégico, surfear los cambios o enraizar lo logrado y sostenerlo en el tiempo.
Accedé al libro aquí.
Fuente: www.lanacion.com.ar
Thursday, December 29, 2016
REL/GralInt-TED Talks-Sharon Brous: It's time to reclaim religion
The following information is used for educational purposes only.
Filmed October 2016 at TEDWomen 2016
Sharon Brous: It's time to reclaim religion
At a moment when the world seems to be spinning out of control, religion might feel irrelevant — or like part of the problem. But Rabbi Sharon Brous believes we can reinvent religion to meet the needs of modern life. In this impassioned talk, Brous shares four principles of a revitalized religious practice and offers faith of all kinds as a hopeful counter-narrative to the numbing realities of violence, extremism and pessimism.
Transcript:
I was a new mother and a young rabbi in the spring of 2004 and the world was in shambles. Maybe you remember. Every day, we heard devastating reports from the war in Iraq. There were waves of terror rolling across the globe. It seemed like humanity was spinning out of control. I remember the night that I read about the series of coordinated bombings in the subway system in Madrid, and I got up and I walked over to the crib where my six-month-old baby girl lay sleeping sweetly, and I heard the rhythm of her breath, and I felt this sense of urgency coursing through my body. We were living through a time of tectonic shifts in ideologies, in politics, in religion, in populations. Everything felt so precarious. And I remember thinking, "My God, what kind of world did we bring this child into? And what was I as a mother and a religious leader willing to do about it?
Of course, I knew it was clear that religion would be a principle battlefield in this rapidly changing landscape, and it was already clear that religion was a significant part of the problem. The question for me was, could religion also be part of the solution? Now, throughout history, people have committed horrible crimes and atrocities in the name of religion. And as we entered the 21st century, it was very clear that religious extremism was once again on the rise. Our studies now show that over the course of the past 15, 20 years, hostilities and religion-related violence have been on the increase all over the world. But we don't even need the studies to prove it, because I ask you, how many of us are surprised today when we hear the stories of a bombing or a shooting, when we later find out that the last word that was uttered before the trigger is pulled or the bomb is detonated is the name of God? It barely raises an eyebrow today when we learn that yet another person has decided to show his love of God by taking the lives of God's children. In America, religious extremism looks like a white, antiabortion Christian extremist walking into Planned Parenthood in Colorado Springs and murdering three people. It also looks like a couple inspired by the Islamic State walking into an office party in San Bernardino and killing 14. And even when religion-related extremism does not lead to violence, it is still used as a political wedge issue, cynically leading people to justify the subordination of women, the stigmatization of LGBT people, racism, Islamophobia and anti-Semitism. This ought to concern deeply those of us who care about the future of religion and the future of faith. We need to call this what it is: a great failure of religion.
But the thing is, this isn't even the only challenge that religion faces today. At the very same time that we need religion to be a strong force against extremism, it is suffering from a second pernicious trend, what I call religious routine-ism. This is when our institutions and our leaders are stuck in a paradigm that is rote and perfunctory, devoid of life, devoid of vision and devoid of soul.
Let me explain what I mean like this. One of the great blessings of being a rabbi is standing under the chuppah, under the wedding canopy, with a couple, and helping them proclaim publicly and make holy the love that they found for one another. I want to ask you now, though, to think maybe from your own experience or maybe just imagine it about the difference between the intensity of the experience under the wedding canopy, and maybe the experience of the sixth or seventh anniversary.
(Laughter)
And if you're lucky enough to make it 16 or 17 years, if you're like most people, you probably wake up in the morning realizing that you forgot to make a reservation at your favorite restaurant and you forgot so much as a card, and then you just hope and pray that your partner also forgot.
Well, religious ritual and rites were essentially designed to serve the function of the anniversary, to be a container in which we would hold on to the remnants of that sacred, revelatory encounter that birthed the religion in the first place. The problem is that after a few centuries, the date remains on the calendar, but the love affair is long dead. That's when we find ourselves in endless, mindless repetitions of words that don't mean anything to us, rising and being seated because someone has asked us to, holding onto jealously guarded doctrine that's completely and wildly out of step with our contemporary reality, engaging in perfunctory practice simply because that's the way things have always been done.
Religion is waning in the United States. Across the board, churches and synagogues and mosques are all complaining about how hard it is to maintain relevance for a generation of young people who seem completely uninterested, not only in the institutions that stand at the heart of our traditions but even in religion itself. And what they need to understand is that there is today a generation of people who are as disgusted by the violence of religious extremism as they are turned off by the lifelessness of religious routine-ism.
Of course there is a bright spot to this story. Given the crisis of these two concurrent trends in religious life, about 12 or 13 years ago, I set out to try to determine if there was any way that I could reclaim the heart of my own Jewish tradition, to help make it meaningful and purposeful again in a world on fire. I started to wonder, what if we could harness some of the great minds of our generation and think in a bold and robust and imaginative way again about what the next iteration of religious life would look like? Now, we had no money, no space, no game plan, but we did have email. So my friend Melissa and I sat down and we wrote an email which we sent out to a few friends and colleagues. It basically said this: "Before you bail on religion, why don't we come together this Friday night and see what we might make of our own Jewish inheritance?"
We hoped maybe 20 people would show up. It turned out 135 people came. They were cynics and seekers, atheists and rabbis. Many people said that night that it was the first time that they had a meaningful religious experience in their entire lives. And so I set out to do the only rational thing that someone would do in such a circumstance: I quit my job and tried to build this audacious dream, a reinvented, rethought religious life which we called "IKAR," which means "the essence" or "the heart of the matter."
Now, IKAR is not alone out there in the religious landscape today. There are Jewish and Christian and Muslim and Catholic religious leaders, many of them women, by the way, who have set out to reclaim the heart of our traditions, who firmly believe that now is the time for religion to be part of the solution. We are going back into our sacred traditions and recognizing that all of our traditions contain the raw material to justify violence and extremism, and also contain the raw material to justify compassion, coexistence and kindness -- that when others choose to read our texts as directives for hate and vengeance, we can choose to read those same texts as directives for love and for forgiveness.
I have found now in communities as varied as Jewish indie start-ups on the coasts to a woman's mosque, to black churches in New York and in North Carolina, to a holy bus loaded with nuns that traverses this country with a message of justice and peace, that there is a shared religious ethos that is now emerging in the form of revitalized religion in this country. And while the theologies and the practices vary very much between these independent communities, what we can see are some common, consistent threads between them.
I'm going to share with you four of those commitments now.
The first is wakefulness. We live in a time today in which we have unprecedented access to information about every global tragedy that happens on every corner of this Earth. Within 12 hours, 20 million people saw that image of Aylan Kurdi's little body washed up on the Turkish shore. We all saw this picture. We saw this picture of a five-year-old child pulled out of the rubble of his building in Aleppo. And once we see these images, we are called to a certain kind of action.
My tradition tells a story of a traveler who is walking down a road when he sees a beautiful house on fire, and he says, "How can it be that something so beautiful would burn, and nobody seems to even care?" So too we learn that our world is on fire, and it is our job to keep our hearts and our eyes open, and to recognize that it's our responsibility to help put out the flames.
This is extremely difficult to do. Psychologists tell us that the more we learn about what's broken in our world, the less likely we are to do anything. It's called psychic numbing. We just shut down at a certain point. Well, somewhere along the way, our religious leaders forgot that it's our job to make people uncomfortable. It's our job to wake people up, to pull them out of their apathy and into the anguish, and to insist that we do what we don't want to do and see what we do not want to see. Because we know that social change only happens -
(Applause)
when we are awake enough to see that the house is on fire.
The second principle is hope, and I want to say this about hope. Hope is not naive, and hope is not an opiate. Hope may be the single greatest act of defiance against a politics of pessimism and against a culture of despair. Because what hope does for us is it lifts us out of the container that holds us and constrains us from the outside, and says, "You can dream and think expansively again. That they cannot control in you."
I saw hope made manifest in an African-American church in the South Side of Chicago this summer, where I brought my little girl, who is now 13 and a few inches taller than me, to hear my friend Rev. Otis Moss preach. That summer, there had already been 3,000 people shot between January and July in Chicago. We went into that church and heard Rev. Moss preach, and after he did, this choir of gorgeous women, 100 women strong, stood up and began to sing. "I need you. You need me. I love you. I need you to survive." And I realized in that moment that this is what religion is supposed to be about. It's supposed to be about giving people back a sense of purpose, a sense of hope, a sense that they and their dreams fundamentally matter in this world that tells them that they don't matter at all.
The third principle is the principle of mightiness. There's a rabbinic tradition that we are to walk around with two slips of paper in our pockets. One says, "I am but dust and ashes." It's not all about me. I can't control everything, and I cannot do this on my own. The other slip of paper says, "For my sake the world was created." Which is to say it's true that I can't do everything, but I can surely do something. I can forgive. I can love. I can show up. I can protest. I can be a part of this conversation. We even now have a religious ritual, a posture, that holds the paradox between powerlessness and power. In the Jewish community, the only time of year that we prostrate fully to the ground is during the high holy days. It's a sign of total submission. Now in our community, when we get up off the ground, we stand with our hands raised to the heavens, and we say, "I am strong, I am mighty, and I am worthy. I can't do everything, but I can do something."
In a world that conspires to make us believe that we are invisible and that we are impotent, religious communities and religious ritual can remind us that for whatever amount of time we have here on this Earth, whatever gifts and blessings we were given, whatever resources we have, we can and we must use them to try to make the world a little bit more just and a little bit more loving.
The fourth and final is interconnectedness. A few years ago, there was a man walking on the beach in Alaska, when he came across a soccer ball that had some Japanese letters written on it. He took a picture of it and posted it up on social media, and a Japanese teenager contacted him. He had lost everything in the tsunami that devastated his country, but he was able to retrieve that soccer ball after it had floated all the way across the Pacific. How small our world has become. It's so hard for us to remember how interconnected we all are as human beings. And yet, we know that it is systems of oppression that benefit the most from the lie of radical individualism.
Let me tell you how this works. I'm not supposed to care when black youth are harassed by police, because my white-looking Jewish kids probably won't ever get pulled over for the crime of driving while black. Well, not so, because this is also my problem. And guess what? Transphobia and Islamophobia and racism of all forms, those are also all of our problems. And so too is anti-Semitism all of our problems. Because Emma Lazarus was right.
(Applause)
Emma Lazarus was right when she said until all of us are free, we are none of us free. We are all in this together. And now somewhere at the intersection of these four trends, of wakefulness and hope and mightiness and interconnectedness, there is a burgeoning, multifaith justice movement in this country that is staking a claim on a countertrend, saying that religion can and must be a force for good in the world.
Our hearts hurt from the failed religion of extremism, and we deserve more than the failed religion of routine-ism. It is time for religious leaders and religious communities to take the lead in the spiritual and cultural shift that this country and the world so desperately needs -- a shift toward love, toward justice, toward equality and toward dignity for all. I believe that our children deserve no less than that.
Thank you.
(Applause)
Filmed October 2016 at TEDWomen 2016
Sharon Brous: It's time to reclaim religion
At a moment when the world seems to be spinning out of control, religion might feel irrelevant — or like part of the problem. But Rabbi Sharon Brous believes we can reinvent religion to meet the needs of modern life. In this impassioned talk, Brous shares four principles of a revitalized religious practice and offers faith of all kinds as a hopeful counter-narrative to the numbing realities of violence, extremism and pessimism.
Transcript:
I was a new mother and a young rabbi in the spring of 2004 and the world was in shambles. Maybe you remember. Every day, we heard devastating reports from the war in Iraq. There were waves of terror rolling across the globe. It seemed like humanity was spinning out of control. I remember the night that I read about the series of coordinated bombings in the subway system in Madrid, and I got up and I walked over to the crib where my six-month-old baby girl lay sleeping sweetly, and I heard the rhythm of her breath, and I felt this sense of urgency coursing through my body. We were living through a time of tectonic shifts in ideologies, in politics, in religion, in populations. Everything felt so precarious. And I remember thinking, "My God, what kind of world did we bring this child into? And what was I as a mother and a religious leader willing to do about it?
Of course, I knew it was clear that religion would be a principle battlefield in this rapidly changing landscape, and it was already clear that religion was a significant part of the problem. The question for me was, could religion also be part of the solution? Now, throughout history, people have committed horrible crimes and atrocities in the name of religion. And as we entered the 21st century, it was very clear that religious extremism was once again on the rise. Our studies now show that over the course of the past 15, 20 years, hostilities and religion-related violence have been on the increase all over the world. But we don't even need the studies to prove it, because I ask you, how many of us are surprised today when we hear the stories of a bombing or a shooting, when we later find out that the last word that was uttered before the trigger is pulled or the bomb is detonated is the name of God? It barely raises an eyebrow today when we learn that yet another person has decided to show his love of God by taking the lives of God's children. In America, religious extremism looks like a white, antiabortion Christian extremist walking into Planned Parenthood in Colorado Springs and murdering three people. It also looks like a couple inspired by the Islamic State walking into an office party in San Bernardino and killing 14. And even when religion-related extremism does not lead to violence, it is still used as a political wedge issue, cynically leading people to justify the subordination of women, the stigmatization of LGBT people, racism, Islamophobia and anti-Semitism. This ought to concern deeply those of us who care about the future of religion and the future of faith. We need to call this what it is: a great failure of religion.
But the thing is, this isn't even the only challenge that religion faces today. At the very same time that we need religion to be a strong force against extremism, it is suffering from a second pernicious trend, what I call religious routine-ism. This is when our institutions and our leaders are stuck in a paradigm that is rote and perfunctory, devoid of life, devoid of vision and devoid of soul.
Let me explain what I mean like this. One of the great blessings of being a rabbi is standing under the chuppah, under the wedding canopy, with a couple, and helping them proclaim publicly and make holy the love that they found for one another. I want to ask you now, though, to think maybe from your own experience or maybe just imagine it about the difference between the intensity of the experience under the wedding canopy, and maybe the experience of the sixth or seventh anniversary.
(Laughter)
And if you're lucky enough to make it 16 or 17 years, if you're like most people, you probably wake up in the morning realizing that you forgot to make a reservation at your favorite restaurant and you forgot so much as a card, and then you just hope and pray that your partner also forgot.
Well, religious ritual and rites were essentially designed to serve the function of the anniversary, to be a container in which we would hold on to the remnants of that sacred, revelatory encounter that birthed the religion in the first place. The problem is that after a few centuries, the date remains on the calendar, but the love affair is long dead. That's when we find ourselves in endless, mindless repetitions of words that don't mean anything to us, rising and being seated because someone has asked us to, holding onto jealously guarded doctrine that's completely and wildly out of step with our contemporary reality, engaging in perfunctory practice simply because that's the way things have always been done.
Religion is waning in the United States. Across the board, churches and synagogues and mosques are all complaining about how hard it is to maintain relevance for a generation of young people who seem completely uninterested, not only in the institutions that stand at the heart of our traditions but even in religion itself. And what they need to understand is that there is today a generation of people who are as disgusted by the violence of religious extremism as they are turned off by the lifelessness of religious routine-ism.
Of course there is a bright spot to this story. Given the crisis of these two concurrent trends in religious life, about 12 or 13 years ago, I set out to try to determine if there was any way that I could reclaim the heart of my own Jewish tradition, to help make it meaningful and purposeful again in a world on fire. I started to wonder, what if we could harness some of the great minds of our generation and think in a bold and robust and imaginative way again about what the next iteration of religious life would look like? Now, we had no money, no space, no game plan, but we did have email. So my friend Melissa and I sat down and we wrote an email which we sent out to a few friends and colleagues. It basically said this: "Before you bail on religion, why don't we come together this Friday night and see what we might make of our own Jewish inheritance?"
We hoped maybe 20 people would show up. It turned out 135 people came. They were cynics and seekers, atheists and rabbis. Many people said that night that it was the first time that they had a meaningful religious experience in their entire lives. And so I set out to do the only rational thing that someone would do in such a circumstance: I quit my job and tried to build this audacious dream, a reinvented, rethought religious life which we called "IKAR," which means "the essence" or "the heart of the matter."
Now, IKAR is not alone out there in the religious landscape today. There are Jewish and Christian and Muslim and Catholic religious leaders, many of them women, by the way, who have set out to reclaim the heart of our traditions, who firmly believe that now is the time for religion to be part of the solution. We are going back into our sacred traditions and recognizing that all of our traditions contain the raw material to justify violence and extremism, and also contain the raw material to justify compassion, coexistence and kindness -- that when others choose to read our texts as directives for hate and vengeance, we can choose to read those same texts as directives for love and for forgiveness.
I have found now in communities as varied as Jewish indie start-ups on the coasts to a woman's mosque, to black churches in New York and in North Carolina, to a holy bus loaded with nuns that traverses this country with a message of justice and peace, that there is a shared religious ethos that is now emerging in the form of revitalized religion in this country. And while the theologies and the practices vary very much between these independent communities, what we can see are some common, consistent threads between them.
I'm going to share with you four of those commitments now.
The first is wakefulness. We live in a time today in which we have unprecedented access to information about every global tragedy that happens on every corner of this Earth. Within 12 hours, 20 million people saw that image of Aylan Kurdi's little body washed up on the Turkish shore. We all saw this picture. We saw this picture of a five-year-old child pulled out of the rubble of his building in Aleppo. And once we see these images, we are called to a certain kind of action.
My tradition tells a story of a traveler who is walking down a road when he sees a beautiful house on fire, and he says, "How can it be that something so beautiful would burn, and nobody seems to even care?" So too we learn that our world is on fire, and it is our job to keep our hearts and our eyes open, and to recognize that it's our responsibility to help put out the flames.
This is extremely difficult to do. Psychologists tell us that the more we learn about what's broken in our world, the less likely we are to do anything. It's called psychic numbing. We just shut down at a certain point. Well, somewhere along the way, our religious leaders forgot that it's our job to make people uncomfortable. It's our job to wake people up, to pull them out of their apathy and into the anguish, and to insist that we do what we don't want to do and see what we do not want to see. Because we know that social change only happens -
(Applause)
when we are awake enough to see that the house is on fire.
The second principle is hope, and I want to say this about hope. Hope is not naive, and hope is not an opiate. Hope may be the single greatest act of defiance against a politics of pessimism and against a culture of despair. Because what hope does for us is it lifts us out of the container that holds us and constrains us from the outside, and says, "You can dream and think expansively again. That they cannot control in you."
I saw hope made manifest in an African-American church in the South Side of Chicago this summer, where I brought my little girl, who is now 13 and a few inches taller than me, to hear my friend Rev. Otis Moss preach. That summer, there had already been 3,000 people shot between January and July in Chicago. We went into that church and heard Rev. Moss preach, and after he did, this choir of gorgeous women, 100 women strong, stood up and began to sing. "I need you. You need me. I love you. I need you to survive." And I realized in that moment that this is what religion is supposed to be about. It's supposed to be about giving people back a sense of purpose, a sense of hope, a sense that they and their dreams fundamentally matter in this world that tells them that they don't matter at all.
The third principle is the principle of mightiness. There's a rabbinic tradition that we are to walk around with two slips of paper in our pockets. One says, "I am but dust and ashes." It's not all about me. I can't control everything, and I cannot do this on my own. The other slip of paper says, "For my sake the world was created." Which is to say it's true that I can't do everything, but I can surely do something. I can forgive. I can love. I can show up. I can protest. I can be a part of this conversation. We even now have a religious ritual, a posture, that holds the paradox between powerlessness and power. In the Jewish community, the only time of year that we prostrate fully to the ground is during the high holy days. It's a sign of total submission. Now in our community, when we get up off the ground, we stand with our hands raised to the heavens, and we say, "I am strong, I am mighty, and I am worthy. I can't do everything, but I can do something."
In a world that conspires to make us believe that we are invisible and that we are impotent, religious communities and religious ritual can remind us that for whatever amount of time we have here on this Earth, whatever gifts and blessings we were given, whatever resources we have, we can and we must use them to try to make the world a little bit more just and a little bit more loving.
The fourth and final is interconnectedness. A few years ago, there was a man walking on the beach in Alaska, when he came across a soccer ball that had some Japanese letters written on it. He took a picture of it and posted it up on social media, and a Japanese teenager contacted him. He had lost everything in the tsunami that devastated his country, but he was able to retrieve that soccer ball after it had floated all the way across the Pacific. How small our world has become. It's so hard for us to remember how interconnected we all are as human beings. And yet, we know that it is systems of oppression that benefit the most from the lie of radical individualism.
Let me tell you how this works. I'm not supposed to care when black youth are harassed by police, because my white-looking Jewish kids probably won't ever get pulled over for the crime of driving while black. Well, not so, because this is also my problem. And guess what? Transphobia and Islamophobia and racism of all forms, those are also all of our problems. And so too is anti-Semitism all of our problems. Because Emma Lazarus was right.
(Applause)
Emma Lazarus was right when she said until all of us are free, we are none of us free. We are all in this together. And now somewhere at the intersection of these four trends, of wakefulness and hope and mightiness and interconnectedness, there is a burgeoning, multifaith justice movement in this country that is staking a claim on a countertrend, saying that religion can and must be a force for good in the world.
Our hearts hurt from the failed religion of extremism, and we deserve more than the failed religion of routine-ism. It is time for religious leaders and religious communities to take the lead in the spiritual and cultural shift that this country and the world so desperately needs -- a shift toward love, toward justice, toward equality and toward dignity for all. I believe that our children deserve no less than that.
Thank you.
(Applause)
GralInt-TED Talks-David Autor: Why are there still so many jobs?
The following information is used for educational purposes only.
Filmed September 2016 at TEDxCambridge
David Autor: Why are there still so many jobs?
Here's a paradox you don't hear much about: despite a century of creating machines to do our work for us, the proportion of adults in the US with a job has consistently gone up for the past 125 years. Why hasn't human labor become redundant and our skills obsolete? In this talk about the future of work, economist David Autor addresses the question of why there are still so many jobs and comes up with a surprising, hopeful answer.
Transcript:
Here's a startling fact: in the 45 years since the introduction of the automated teller machine, those vending machines that dispense cash, the number of human bank tellers employed in the United States has roughly doubled, from about a quarter of a million to a half a million. A quarter of a million in 1970 to about a half a million today, with 100,000 added since the year 2000.
These facts, revealed in a recent book by Boston University economist James Bessen, raise an intriguing question: what are all those tellers doing, and why hasn't automation eliminated their employment by now? If you think about it, many of the great inventions of the last 200 years were designed to replace human labor. Tractors were developed to substitute mechanical power for human physical toil. Assembly lines were engineered to replace inconsistent human handiwork with machine perfection. Computers were programmed to swap out error-prone, inconsistent human calculation with digital perfection. These inventions have worked. We no longer dig ditches by hand, pound tools out of wrought iron or do bookkeeping using actual books. And yet, the fraction of US adults employed in the labor market is higher now in 2016 than it was 125 years ago, in 1890, and it's risen in just about every decade in the intervening 125 years.
This poses a paradox. Our machines increasingly do our work for us. Why doesn't this make our labor redundant and our skills obsolete? Why are there still so many jobs?
(Laughter)
I'm going to try to answer that question tonight, and along the way, I'm going to tell you what this means for the future of work and the challenges that automation does and does not pose for our society.
Why are there so many jobs? There are actually two fundamental economic principles at stake. One has to do with human genius and creativity. The other has to do with human insatiability, or greed, if you like. I'm going to call the first of these the O-ring principle, and it determines the type of work that we do. The second principle is the never-get-enough principle, and it determines how many jobs there actually are.
Let's start with the O-ring. ATMs, automated teller machines, had two countervailing effects on bank teller employment. As you would expect, they replaced a lot of teller tasks. The number of tellers per branch fell by about a third. But banks quickly discovered that it also was cheaper to open new branches, and the number of bank branches increased by about 40 percent in the same time period. The net result was more branches and more tellers. But those tellers were doing somewhat different work. As their routine, cash-handling tasks receded, they became less like checkout clerks and more like salespeople, forging relationships with customers, solving problems and introducing them to new products like credit cards, loans and investments: more tellers doing a more cognitively demanding job. There's a general principle here. Most of the work that we do requires a multiplicity of skills, and brains and brawn, technical expertise and intuitive mastery, perspiration and inspiration in the words of Thomas Edison. In general, automating some subset of those tasks doesn't make the other ones unnecessary. In fact, it makes them more important. It increases their economic value.
Let me give you a stark example. In 1986, the space shuttle Challenger exploded and crashed back down to Earth less than two minutes after takeoff. The cause of that crash, it turned out, was an inexpensive rubber O-ring in the booster rocket that had frozen on the launchpad the night before and failed catastrophically moments after takeoff. In this multibillion dollar enterprise that simple rubber O-ring made the difference between mission success and the calamitous death of seven astronauts. An ingenious metaphor for this tragic setting is the O-ring production function, named by Harvard economist Michael Kremer after the Challenger disaster. The O-ring production function conceives of the work as a series of interlocking steps, links in a chain. Every one of those links must hold for the mission to succeed. If any of them fails, the mission, or the product or the service, comes crashing down. This precarious situation has a surprisingly positive implication, which is that improvements in the reliability of any one link in the chain increases the value of improving any of the other links. Concretely, if most of the links are brittle and prone to breakage, the fact that your link is not that reliable is not that important. Probably something else will break anyway. But as all the other links become robust and reliable, the importance of your link becomes more essential. In the limit, everything depends upon it. The reason the O-ring was critical to space shuttle Challenger is because everything else worked perfectly. If the Challenger were kind of the space era equivalent of Microsoft Windows 2000 -
(Laughter)
the reliability of the O-ring wouldn't have mattered because the machine would have crashed.
(Laughter)
Here's the broader point. In much of the work that we do, we are the O-rings. Yes, ATMs could do certain cash-handling tasks faster and better than tellers, but that didn't make tellers superfluous. It increased the importance of their problem-solving skills and their relationships with customers. The same principle applies if we're building a building, if we're diagnosing and caring for a patient, or if we are teaching a class to a roomful of high schoolers. As our tools improve, technology magnifies our leverage and increases the importance of our expertise and our judgment and our creativity.
And that brings me to the second principle: never get enough. You may be thinking, OK, O-ring, got it, that says the jobs that people do will be important. They can't be done by machines, but they still need to be done. But that doesn't tell me how many jobs there will need to be. If you think about it, isn't it kind of self-evident that once we get sufficiently productive at something, we've basically worked our way out of a job? In 1900, 40 percent of all US employment was on farms. Today, it's less than two percent. Why are there so few farmers today? It's not because we're eating less.
(Laughter)
A century of productivity growth in farming means that now, a couple of million farmers can feed a nation of 320 million. That's amazing progress, but it also means there are only so many O-ring jobs left in farming. So clearly, technology can eliminate jobs. Farming is only one example. There are many others like it. But what's true about a single product or service or industry has never been true about the economy as a whole. Many of the industries in which we now work -- health and medicine, finance and insurance, electronics and computing -- were tiny or barely existent a century ago. Many of the products that we spend a lot of our money on -- air conditioners, sport utility vehicles, computers and mobile devices -- were unattainably expensive, or just hadn't been invented a century ago. As automation frees our time, increases the scope of what is possible, we invent new products, new ideas, new services that command our attention, occupy our time and spur consumption. You may think some of these things are frivolous -- extreme yoga, adventure tourism, Pokémon GO -- and I might agree with you. But people desire these things, and they're willing to work hard for them. The average worker in 2015 wanting to attain the average living standard in 1915 could do so by working just 17 weeks a year, one third of the time. But most people don't choose to do that. They are willing to work hard to harvest the technological bounty that is available to them. Material abundance has never eliminated perceived scarcity. In the words of economist Thorstein Veblen, invention is the mother of necessity.
Now ... So if you accept these two principles, the O-ring principle and the never-get-enough principle, then you agree with me. There will be jobs. Does that mean there's nothing to worry about? Automation, employment, robots and jobs -- it'll all take care of itself? No. That is not my argument. Automation creates wealth by allowing us to do more work in less time. There is no economic law that says that we will use that wealth well, and that is worth worrying about. Consider two countries, Norway and Saudi Arabia. Both oil-rich nations, it's like they have money spurting out of a hole in the ground.
(Laughter)
But they haven't used that wealth equally well to foster human prosperity, human prospering. Norway is a thriving democracy. By and large, its citizens work and play well together. It's typically numbered between first and fourth in rankings of national happiness. Saudi Arabia is an absolute monarchy in which many citizens lack a path for personal advancement. It's typically ranked 35th among nations in happiness, which is low for such a wealthy nation. Just by way of comparison, the US is typically ranked around 12th or 13th. The difference between these two countries is not their wealth and it's not their technology. It's their institutions. Norway has invested to build a society with opportunity and economic mobility. Saudi Arabia has raised living standards while frustrating many other human strivings. Two countries, both wealthy, not equally well off.
And this brings me to the challenge that we face today, the challenge that automation poses for us. The challenge is not that we're running out of work. The US has added 14 million jobs since the depths of the Great Recession. The challenge is that many of those jobs are not good jobs, and many citizens cannot qualify for the good jobs that are being created. Employment growth in the United States and in much of the developed world looks something like a barbell with increasing poundage on either end of the bar. On the one hand, you have high-education, high-wage jobs like doctors and nurses, programmers and engineers, marketing and sales managers. Employment is robust in these jobs, employment growth. Similarly, employment growth is robust in many low-skill, low-education jobs like food service, cleaning, security, home health aids. Simultaneously, employment is shrinking in many middle-education, middle-wage, middle-class jobs, like blue-collar production and operative positions and white-collar clerical and sales positions. The reasons behind this contracting middle are not mysterious. Many of those middle-skill jobs use well-understood rules and procedures that can increasingly be codified in software and executed by computers. The challenge that this phenomenon creates, what economists call employment polarization, is that it knocks out rungs in the economic ladder, shrinks the size of the middle class and threatens to make us a more stratified society. On the one hand, a set of highly paid, highly educated professionals doing interesting work, on the other, a large number of citizens in low-paid jobs whose primary responsibility is to see to the comfort and health of the affluent. That is not my vision of progress, and I doubt that it is yours.
But here is some encouraging news. We have faced equally momentous economic transformations in the past, and we have come through them successfully. In the late 1800s and early 1900s, when automation was eliminating vast numbers of agricultural jobs -- remember that tractor? -- the farm states faced a threat of mass unemployment, a generation of youth no longer needed on the farm but not prepared for industry. Rising to this challenge, they took the radical step of requiring that their entire youth population remain in school and continue their education to the ripe old age of 16. This was called the high school movement, and it was a radically expensive thing to do. Not only did they have to invest in the schools, but those kids couldn't work at their jobs. It also turned out to be one of the best investments the US made in the 20th century. It gave us the most skilled, the most flexible and the most productive workforce in the world. To see how well this worked, imagine taking the labor force of 1899 and bringing them into the present. Despite their strong backs and good characters, many of them would lack the basic literacy and numeracy skills to do all but the most mundane jobs. Many of them would be unemployable.
What this example highlights is the primacy of our institutions, most especially our schools, in allowing us to reap the harvest of our technological prosperity.
It's foolish to say there's nothing to worry about. Clearly we can get this wrong. If the US had not invested in its schools and in its skills a century ago with the high school movement, we would be a less prosperous, a less mobile and probably a lot less happy society. But it's equally foolish to say that our fates are sealed. That's not decided by the machines. It's not even decided by the market. It's decided by us and by our institutions.
Now, I started this talk with a paradox. Our machines increasingly do our work for us. Why doesn't that make our labor superfluous, our skills redundant? Isn't it obvious that the road to our economic and social hell is paved with our own great inventions?
History has repeatedly offered an answer to that paradox. The first part of the answer is that technology magnifies our leverage, increases the importance, the added value of our expertise, our judgment and our creativity. That's the O-ring. The second part of the answer is our endless inventiveness and bottomless desires means that we never get enough, never get enough. There's always new work to do. Adjusting to the rapid pace of technological change creates real challenges, seen most clearly in our polarized labor market and the threat that it poses to economic mobility. Rising to this challenge is not automatic. It's not costless. It's not easy. But it is feasible. And here is some encouraging news. Because of our amazing productivity, we're rich. Of course we can afford to invest in ourselves and in our children as America did a hundred years ago with the high school movement. Arguably, we can't afford not to.
Now, you may be thinking, Professor Autor has told us a heartwarming tale about the distant past, the recent past, maybe the present, but probably not the future. Because everybody knows that this time is different. Right? Is this time different? Of course this time is different. Every time is different. On numerous occasions in the last 200 years, scholars and activists have raised the alarm that we are running out of work and making ourselves obsolete: for example, the Luddites in the early 1800s; US Secretary of Labor James Davis in the mid-1920s; Nobel Prize-winning economist Wassily Leontief in 1982; and of course, many scholars, pundits, technologists and media figures today.
These predictions strike me as arrogant. These self-proclaimed oracles are in effect saying, "If I can't think of what people will do for work in the future, then you, me and our kids aren't going to think of it either." I don't have the guts to take that bet against human ingenuity. Look, I can't tell you what people are going to do for work a hundred years from now. But the future doesn't hinge on my imagination. If I were a farmer in Iowa in the year 1900, and an economist from the 21st century teleported down to my field and said, "Hey, guess what, farmer Autor, in the next hundred years, agricultural employment is going to fall from 40 percent of all jobs to two percent purely due to rising productivity. What do you think the other 38 percent of workers are going to do?" I would not have said, "Oh, we got this. We'll do app development, radiological medicine, yoga instruction, Bitmoji."
(Laughter)
I wouldn't have had a clue. But I hope I would have had the wisdom to say, "Wow, a 95 percent reduction in farm employment with no shortage of food. That's an amazing amount of progress. I hope that humanity finds something remarkable to do with all of that prosperity."
And by and large, I would say that it has.
Thank you very much.
(Applause)
Filmed September 2016 at TEDxCambridge
David Autor: Why are there still so many jobs?
Here's a paradox you don't hear much about: despite a century of creating machines to do our work for us, the proportion of adults in the US with a job has consistently gone up for the past 125 years. Why hasn't human labor become redundant and our skills obsolete? In this talk about the future of work, economist David Autor addresses the question of why there are still so many jobs and comes up with a surprising, hopeful answer.
Transcript:
Here's a startling fact: in the 45 years since the introduction of the automated teller machine, those vending machines that dispense cash, the number of human bank tellers employed in the United States has roughly doubled, from about a quarter of a million to a half a million. A quarter of a million in 1970 to about a half a million today, with 100,000 added since the year 2000.
These facts, revealed in a recent book by Boston University economist James Bessen, raise an intriguing question: what are all those tellers doing, and why hasn't automation eliminated their employment by now? If you think about it, many of the great inventions of the last 200 years were designed to replace human labor. Tractors were developed to substitute mechanical power for human physical toil. Assembly lines were engineered to replace inconsistent human handiwork with machine perfection. Computers were programmed to swap out error-prone, inconsistent human calculation with digital perfection. These inventions have worked. We no longer dig ditches by hand, pound tools out of wrought iron or do bookkeeping using actual books. And yet, the fraction of US adults employed in the labor market is higher now in 2016 than it was 125 years ago, in 1890, and it's risen in just about every decade in the intervening 125 years.
This poses a paradox. Our machines increasingly do our work for us. Why doesn't this make our labor redundant and our skills obsolete? Why are there still so many jobs?
(Laughter)
I'm going to try to answer that question tonight, and along the way, I'm going to tell you what this means for the future of work and the challenges that automation does and does not pose for our society.
Why are there so many jobs? There are actually two fundamental economic principles at stake. One has to do with human genius and creativity. The other has to do with human insatiability, or greed, if you like. I'm going to call the first of these the O-ring principle, and it determines the type of work that we do. The second principle is the never-get-enough principle, and it determines how many jobs there actually are.
Let's start with the O-ring. ATMs, automated teller machines, had two countervailing effects on bank teller employment. As you would expect, they replaced a lot of teller tasks. The number of tellers per branch fell by about a third. But banks quickly discovered that it also was cheaper to open new branches, and the number of bank branches increased by about 40 percent in the same time period. The net result was more branches and more tellers. But those tellers were doing somewhat different work. As their routine, cash-handling tasks receded, they became less like checkout clerks and more like salespeople, forging relationships with customers, solving problems and introducing them to new products like credit cards, loans and investments: more tellers doing a more cognitively demanding job. There's a general principle here. Most of the work that we do requires a multiplicity of skills, and brains and brawn, technical expertise and intuitive mastery, perspiration and inspiration in the words of Thomas Edison. In general, automating some subset of those tasks doesn't make the other ones unnecessary. In fact, it makes them more important. It increases their economic value.
Let me give you a stark example. In 1986, the space shuttle Challenger exploded and crashed back down to Earth less than two minutes after takeoff. The cause of that crash, it turned out, was an inexpensive rubber O-ring in the booster rocket that had frozen on the launchpad the night before and failed catastrophically moments after takeoff. In this multibillion dollar enterprise that simple rubber O-ring made the difference between mission success and the calamitous death of seven astronauts. An ingenious metaphor for this tragic setting is the O-ring production function, named by Harvard economist Michael Kremer after the Challenger disaster. The O-ring production function conceives of the work as a series of interlocking steps, links in a chain. Every one of those links must hold for the mission to succeed. If any of them fails, the mission, or the product or the service, comes crashing down. This precarious situation has a surprisingly positive implication, which is that improvements in the reliability of any one link in the chain increases the value of improving any of the other links. Concretely, if most of the links are brittle and prone to breakage, the fact that your link is not that reliable is not that important. Probably something else will break anyway. But as all the other links become robust and reliable, the importance of your link becomes more essential. In the limit, everything depends upon it. The reason the O-ring was critical to space shuttle Challenger is because everything else worked perfectly. If the Challenger were kind of the space era equivalent of Microsoft Windows 2000 -
(Laughter)
the reliability of the O-ring wouldn't have mattered because the machine would have crashed.
(Laughter)
Here's the broader point. In much of the work that we do, we are the O-rings. Yes, ATMs could do certain cash-handling tasks faster and better than tellers, but that didn't make tellers superfluous. It increased the importance of their problem-solving skills and their relationships with customers. The same principle applies if we're building a building, if we're diagnosing and caring for a patient, or if we are teaching a class to a roomful of high schoolers. As our tools improve, technology magnifies our leverage and increases the importance of our expertise and our judgment and our creativity.
And that brings me to the second principle: never get enough. You may be thinking, OK, O-ring, got it, that says the jobs that people do will be important. They can't be done by machines, but they still need to be done. But that doesn't tell me how many jobs there will need to be. If you think about it, isn't it kind of self-evident that once we get sufficiently productive at something, we've basically worked our way out of a job? In 1900, 40 percent of all US employment was on farms. Today, it's less than two percent. Why are there so few farmers today? It's not because we're eating less.
(Laughter)
A century of productivity growth in farming means that now, a couple of million farmers can feed a nation of 320 million. That's amazing progress, but it also means there are only so many O-ring jobs left in farming. So clearly, technology can eliminate jobs. Farming is only one example. There are many others like it. But what's true about a single product or service or industry has never been true about the economy as a whole. Many of the industries in which we now work -- health and medicine, finance and insurance, electronics and computing -- were tiny or barely existent a century ago. Many of the products that we spend a lot of our money on -- air conditioners, sport utility vehicles, computers and mobile devices -- were unattainably expensive, or just hadn't been invented a century ago. As automation frees our time, increases the scope of what is possible, we invent new products, new ideas, new services that command our attention, occupy our time and spur consumption. You may think some of these things are frivolous -- extreme yoga, adventure tourism, Pokémon GO -- and I might agree with you. But people desire these things, and they're willing to work hard for them. The average worker in 2015 wanting to attain the average living standard in 1915 could do so by working just 17 weeks a year, one third of the time. But most people don't choose to do that. They are willing to work hard to harvest the technological bounty that is available to them. Material abundance has never eliminated perceived scarcity. In the words of economist Thorstein Veblen, invention is the mother of necessity.
Now ... So if you accept these two principles, the O-ring principle and the never-get-enough principle, then you agree with me. There will be jobs. Does that mean there's nothing to worry about? Automation, employment, robots and jobs -- it'll all take care of itself? No. That is not my argument. Automation creates wealth by allowing us to do more work in less time. There is no economic law that says that we will use that wealth well, and that is worth worrying about. Consider two countries, Norway and Saudi Arabia. Both oil-rich nations, it's like they have money spurting out of a hole in the ground.
(Laughter)
But they haven't used that wealth equally well to foster human prosperity, human prospering. Norway is a thriving democracy. By and large, its citizens work and play well together. It's typically numbered between first and fourth in rankings of national happiness. Saudi Arabia is an absolute monarchy in which many citizens lack a path for personal advancement. It's typically ranked 35th among nations in happiness, which is low for such a wealthy nation. Just by way of comparison, the US is typically ranked around 12th or 13th. The difference between these two countries is not their wealth and it's not their technology. It's their institutions. Norway has invested to build a society with opportunity and economic mobility. Saudi Arabia has raised living standards while frustrating many other human strivings. Two countries, both wealthy, not equally well off.
And this brings me to the challenge that we face today, the challenge that automation poses for us. The challenge is not that we're running out of work. The US has added 14 million jobs since the depths of the Great Recession. The challenge is that many of those jobs are not good jobs, and many citizens cannot qualify for the good jobs that are being created. Employment growth in the United States and in much of the developed world looks something like a barbell with increasing poundage on either end of the bar. On the one hand, you have high-education, high-wage jobs like doctors and nurses, programmers and engineers, marketing and sales managers. Employment is robust in these jobs, employment growth. Similarly, employment growth is robust in many low-skill, low-education jobs like food service, cleaning, security, home health aids. Simultaneously, employment is shrinking in many middle-education, middle-wage, middle-class jobs, like blue-collar production and operative positions and white-collar clerical and sales positions. The reasons behind this contracting middle are not mysterious. Many of those middle-skill jobs use well-understood rules and procedures that can increasingly be codified in software and executed by computers. The challenge that this phenomenon creates, what economists call employment polarization, is that it knocks out rungs in the economic ladder, shrinks the size of the middle class and threatens to make us a more stratified society. On the one hand, a set of highly paid, highly educated professionals doing interesting work, on the other, a large number of citizens in low-paid jobs whose primary responsibility is to see to the comfort and health of the affluent. That is not my vision of progress, and I doubt that it is yours.
But here is some encouraging news. We have faced equally momentous economic transformations in the past, and we have come through them successfully. In the late 1800s and early 1900s, when automation was eliminating vast numbers of agricultural jobs -- remember that tractor? -- the farm states faced a threat of mass unemployment, a generation of youth no longer needed on the farm but not prepared for industry. Rising to this challenge, they took the radical step of requiring that their entire youth population remain in school and continue their education to the ripe old age of 16. This was called the high school movement, and it was a radically expensive thing to do. Not only did they have to invest in the schools, but those kids couldn't work at their jobs. It also turned out to be one of the best investments the US made in the 20th century. It gave us the most skilled, the most flexible and the most productive workforce in the world. To see how well this worked, imagine taking the labor force of 1899 and bringing them into the present. Despite their strong backs and good characters, many of them would lack the basic literacy and numeracy skills to do all but the most mundane jobs. Many of them would be unemployable.
What this example highlights is the primacy of our institutions, most especially our schools, in allowing us to reap the harvest of our technological prosperity.
It's foolish to say there's nothing to worry about. Clearly we can get this wrong. If the US had not invested in its schools and in its skills a century ago with the high school movement, we would be a less prosperous, a less mobile and probably a lot less happy society. But it's equally foolish to say that our fates are sealed. That's not decided by the machines. It's not even decided by the market. It's decided by us and by our institutions.
Now, I started this talk with a paradox. Our machines increasingly do our work for us. Why doesn't that make our labor superfluous, our skills redundant? Isn't it obvious that the road to our economic and social hell is paved with our own great inventions?
History has repeatedly offered an answer to that paradox. The first part of the answer is that technology magnifies our leverage, increases the importance, the added value of our expertise, our judgment and our creativity. That's the O-ring. The second part of the answer is our endless inventiveness and bottomless desires means that we never get enough, never get enough. There's always new work to do. Adjusting to the rapid pace of technological change creates real challenges, seen most clearly in our polarized labor market and the threat that it poses to economic mobility. Rising to this challenge is not automatic. It's not costless. It's not easy. But it is feasible. And here is some encouraging news. Because of our amazing productivity, we're rich. Of course we can afford to invest in ourselves and in our children as America did a hundred years ago with the high school movement. Arguably, we can't afford not to.
Now, you may be thinking, Professor Autor has told us a heartwarming tale about the distant past, the recent past, maybe the present, but probably not the future. Because everybody knows that this time is different. Right? Is this time different? Of course this time is different. Every time is different. On numerous occasions in the last 200 years, scholars and activists have raised the alarm that we are running out of work and making ourselves obsolete: for example, the Luddites in the early 1800s; US Secretary of Labor James Davis in the mid-1920s; Nobel Prize-winning economist Wassily Leontief in 1982; and of course, many scholars, pundits, technologists and media figures today.
These predictions strike me as arrogant. These self-proclaimed oracles are in effect saying, "If I can't think of what people will do for work in the future, then you, me and our kids aren't going to think of it either." I don't have the guts to take that bet against human ingenuity. Look, I can't tell you what people are going to do for work a hundred years from now. But the future doesn't hinge on my imagination. If I were a farmer in Iowa in the year 1900, and an economist from the 21st century teleported down to my field and said, "Hey, guess what, farmer Autor, in the next hundred years, agricultural employment is going to fall from 40 percent of all jobs to two percent purely due to rising productivity. What do you think the other 38 percent of workers are going to do?" I would not have said, "Oh, we got this. We'll do app development, radiological medicine, yoga instruction, Bitmoji."
(Laughter)
I wouldn't have had a clue. But I hope I would have had the wisdom to say, "Wow, a 95 percent reduction in farm employment with no shortage of food. That's an amazing amount of progress. I hope that humanity finds something remarkable to do with all of that prosperity."
And by and large, I would say that it has.
Thank you very much.
(Applause)
MED/SC/GralInt-TED Talks-Kevin B. Jones: Why curiosity is the key to science and medicine
The following information is used for educational purposes only.
Filmed September 2015 at TEDxSaltLakeCity
Kevin B. Jones: Why curiosity is the key to science and medicine
Science is a learning process that involves experimentation, failure and revision — and the science of medicine is no exception. Cancer researcher Kevin B. Jones faces the deep unknowns about surgery and medical care with a simple answer: honesty. In a thoughtful talk about the nature of knowledge, Jones shows how science is at its best when scientists humbly admit what they do not yet understand.
Transcript:
Science. The very word for many of you conjures unhappy memories of boredom in high school biology or physics class. But let me assure that what you did there had very little to do with science. That was really the "what" of science. It was the history of what other people had discovered. What I'm most interested in as a scientist is the "how" of science. Because science is knowledge in process. We make an observation, guess an explanation for that observation, and then make a prediction that we can test with an experiment or other observation.
A couple of examples. First of all, people noticed that the Earth was below, the sky above, and both the Sun and the Moon seemed to go around them. Their guessed explanation was that the Earth must be the center of the universe. The prediction: everything should circle around the Earth. This was first really tested when Galileo got his hands on one of the first telescopes, and as he gazed into the night sky, what he found there was a planet, Jupiter, with four moons circling around it. He then used those moons to follow the path of Jupiter and found that Jupiter also was not going around the Earth but around the Sun. So the prediction test failed. And this led to the discarding of the theory that the Earth was the center of the universe.
Another example: Sir Isaac Newton noticed that things fall to the Earth. The guessed explanation was gravity, the prediction that everything should fall to the Earth. But of course, not everything does fall to the Earth. So did we discard gravity? No. We revised the theory and said, gravity pulls things to the Earth unless there is an equal and opposite force in the other direction. This led us to learn something new. We began to pay more attention to the bird and the bird's wings, and just think of all the discoveries that have flown from that line of thinking. So the test failures, the exceptions, the outliers teach us what we don't know and lead us to something new. This is how science moves forward. This is how science learns.
Sometimes in the media, and even more rarely, but sometimes even scientists will say that something or other has been scientifically proven. But I hope that you understand that science never proves anything definitively forever. Hopefully science remains curious enough to look for and humble enough to recognize when we have found the next outlier, the next exception, which, like Jupiter's moons, teaches us what we don't actually know.
We're going to change gears here for a second. The caduceus, or the symbol of medicine, means a lot of different things to different people, but most of our public discourse on medicine really turns it into an engineering problem. We have the hallways of Congress, and the boardrooms of insurance companies that try to figure out how to pay for it. The ethicists and epidemiologists try to figure out how best to distribute medicine, and the hospitals and physicians are absolutely obsessed with their protocols and checklists, trying to figure out how best to safely apply medicine. These are all good things. However, they also all assume at some level that the textbook of medicine is closed. We start to measure the quality of our health care by how quickly we can access it. It doesn't surprise me that in this climate, many of our institutions for the provision of health care start to look a heck of a lot like Jiffy Lube.
(Laughter)
The only problem is that when I graduated from medical school, I didn't get one of those little doohickeys that your mechanic has to plug into your car and find out exactly what's wrong with it, because the textbook of medicine is not closed. Medicine is science. Medicine is knowledge in process. We make an observation, we guess an explanation of that observation, and then we make a prediction that we can test. Now, the testing ground of most predictions in medicine is populations. And you may remember from those boring days in biology class that populations tend to distribute around a mean as a Gaussian or a normal curve. Therefore, in medicine, after we make a prediction from a guessed explanation, we test it in a population. That means that what we know in medicine, our knowledge and our know-how, comes from populations but extends only as far as the next outlier, the next exception, which, like Jupiter's moons, will teach us what we don't actually know.
Now, I am a surgeon who looks after patients with sarcoma. Sarcoma is a very rare form of cancer. It's the cancer of flesh and bones. And I would tell you that every one of my patients is an outlier, is an exception. There is no surgery I have ever performed for a sarcoma patient that has ever been guided by a randomized controlled clinical trial, what we consider the best kind of population-based evidence in medicine. People talk about thinking outside the box, but we don't even have a box in sarcoma. What we do have as we take a bath in the uncertainty and unknowns and exceptions and outliers that surround us in sarcoma is easy access to what I think are those two most important values for any science: humility and curiosity. Because if I am humble and curious, when a patient asks me a question, and I don't know the answer, I'll ask a colleague who may have a similar albeit distinct patient with sarcoma. We'll even establish international collaborations. Those patients will start to talk to each other through chat rooms and support groups. It's through this kind of humbly curious communication that we begin to try and learn new things.
As an example, this is a patient of mine who had a cancer near his knee. Because of humbly curious communication in international collaborations, we have learned that we can repurpose the ankle to serve as the knee when we have to remove the knee with the cancer. He can then wear a prosthetic and run and jump and play. This opportunity was available to him because of international collaborations. It was desirable to him because he had contacted other patients who had experienced it. And so exceptions and outliers in medicine teach us what we don't know, but also lead us to new thinking.
Now, very importantly, all the new thinking that outliers and exceptions lead us to in medicine does not only apply to the outliers and exceptions. It is not that we only learn from sarcoma patients ways to manage sarcoma patients. Sometimes, the outliers and the exceptions teach us things that matter quite a lot to the general population. Like a tree standing outside a forest, the outliers and the exceptions draw our attention and lead us into a much greater sense of perhaps what a tree is. We often talk about losing the forests for the trees, but one also loses a tree within a forest. But the tree that stands out by itself makes those relationships that define a tree, the relationships between trunk and roots and branches, much more apparent. Even if that tree is crooked or even if that tree has very unusual relationships between trunk and roots and branches, it nonetheless draws our attention and allows us to make observations that we can then test in the general population.
I told you that sarcomas are rare. They make up about one percent of all cancers. You also probably know that cancer is considered a genetic disease. By genetic disease we mean that cancer is caused by oncogenes that are turned on in cancer and tumor suppressor genes that are turned off to cause cancer. You might think that we learned about oncogenes and tumor suppressor genes from common cancers like breast cancer and prostate cancer and lung cancer, but you'd be wrong. We learned about oncogenes and tumor suppressor genes for the first time in that itty-bitty little one percent of cancers called sarcoma. In 1966, Peyton Rous got the Nobel Prize for realizing that chickens had a transmissible form of sarcoma. Thirty years later, Harold Varmus and Mike Bishop discovered what that transmissible element was. It was a virus carrying a gene, the src oncogene. Now, I will not tell you that src is the most important oncogene. I will not tell you that src is the most frequently turned on oncogene in all of cancer. But it was the first oncogene. The exception, the outlier drew our attention and led us to something that taught us very important things about the rest of biology.
Now, TP53 is the most important tumor suppressor gene. It is the most frequently turned off tumor suppressor gene in almost every kind of cancer. But we didn't learn about it from common cancers. We learned about it when doctors Li and Fraumeni were looking at families, and they realized that these families had way too many sarcomas. I told you that sarcoma is rare. Remember that a one in a million diagnosis, if it happens twice in one family, is way too common in that family. The very fact that these are rare draws our attention and leads us to new kinds of thinking.
Now, many of you may say, and may rightly say, that yeah, Kevin, that's great, but you're not talking about a bird's wing. You're not talking about moons floating around some planet Jupiter. This is a person. This outlier, this exception, may lead to the advancement of science, but this is a person. And all I can say is that I know that all too well. I have conversations with these patients with rare and deadly diseases. I write about these conversations. These conversations are terribly fraught. They're fraught with horrible phrases like "I have bad news" or "There's nothing more we can do." Sometimes these conversations turn on a single word: "terminal."
Silence can also be rather uncomfortable. Where the blanks are in medicine can be just as important as the words that we use in these conversations. What are the unknowns? What are the experiments that are being done?
Do this little exercise with me. Up there on the screen, you see this phrase, "no where." Notice where the blank is. If we move that blank one space over "no where" becomes "now here," the exact opposite meaning, just by shifting the blank one space over.
I'll never forget the night that I walked into one of my patients' rooms. I had been operating long that day but I still wanted to come and see him. He was a boy I had diagnosed with a bone cancer a few days before. He and his mother had been meeting with the chemotherapy doctors earlier that day, and he had been admitted to the hospital to begin chemotherapy. It was almost midnight when I got to his room. He was asleep, but I found his mother reading by flashlight next to his bed. She came out in the hall to chat with me for a few minutes. It turned out that what she had been reading was the protocol that the chemotherapy doctors had given her that day. She had memorized it. She said, "Dr. Jones, you told me that we don't always win with this type of cancer, but I've been studying this protocol, and I think I can do it. I think I can comply with these very difficult treatments. I'm going to quit my job. I'm going to move in with my parents. I'm going to keep my baby safe." I didn't tell her. I didn't stop to correct her thinking. She was trusting in a protocol that even if complied with, wouldn't necessarily save her son. I didn't tell her. I didn't fill in that blank. But a year and a half later her boy nonetheless died of his cancer. Should I have told her?
Now, many of you may say, "So what? I don't have sarcoma. No one in my family has sarcoma. And this is all fine and well, but it probably doesn't matter in my life." And you're probably right. Sarcoma may not matter a whole lot in your life. But where the blanks are in medicine does matter in your life.
I didn't tell you one dirty little secret. I told you that in medicine, we test predictions in populations, but I didn't tell you, and so often medicine never tells you that every time an individual encounters medicine, even if that individual is firmly embedded in the general population, neither the individual nor the physician knows where in that population the individual will land. Therefore, every encounter with medicine is an experiment. You will be a subject in an experiment. And the outcome will be either a better or a worse result for you. As long as medicine works well, we're fine with fast service, bravado, brimmingly confident conversations. But when things don't work well, sometimes we want something different.
A colleague of mine removed a tumor from a patient's limb. He was concerned about this tumor. In our physician conferences, he talked about his concern that this was a type of tumor that had a high risk for coming back in the same limb. But his conversations with the patient were exactly what a patient might want: brimming with confidence. He said, "I got it all and you're good to go." She and her husband were thrilled. They went out, celebrated, fancy dinner, opened a bottle of champagne. The only problem was a few weeks later, she started to notice another nodule in the same area. It turned out he hadn't gotten it all, and she wasn't good to go. But what happened at this juncture absolutely fascinates me. My colleague came to me and said, "Kevin, would you mind looking after this patient for me?" I said, "Why, you know the right thing to do as well as I do. You haven't done anything wrong." He said, "Please, just look after this patient for me." He was embarrassed -- not by what he had done, but by the conversation that he had had, by the overconfidence.
So I performed a much more invasive surgery and had a very different conversation with the patient afterwards. I said, "Most likely I've gotten it all and you're most likely good to go, but this is the experiment that we're doing. This is what you're going to watch for. This is what I'm going to watch for. And we're going to work together to find out if this surgery will work to get rid of your cancer." I can guarantee you, she and her husband did not crack another bottle of champagne after talking to me. But she was now a scientist, not only a subject in her experiment.
And so I encourage you to seek humility and curiosity in your physicians. Almost 20 billion times each year, a person walks into a doctor's office, and that person becomes a patient. You or someone you love will be that patient sometime very soon. How will you talk to your doctors? What will you tell them? What will they tell you? They cannot tell you what they do not know, but they can tell you when they don't know if only you'll ask. So please, join the conversation.
Thank you.
(Applause)
Filmed September 2015 at TEDxSaltLakeCity
Kevin B. Jones: Why curiosity is the key to science and medicine
Science is a learning process that involves experimentation, failure and revision — and the science of medicine is no exception. Cancer researcher Kevin B. Jones faces the deep unknowns about surgery and medical care with a simple answer: honesty. In a thoughtful talk about the nature of knowledge, Jones shows how science is at its best when scientists humbly admit what they do not yet understand.
Transcript:
Science. The very word for many of you conjures unhappy memories of boredom in high school biology or physics class. But let me assure that what you did there had very little to do with science. That was really the "what" of science. It was the history of what other people had discovered. What I'm most interested in as a scientist is the "how" of science. Because science is knowledge in process. We make an observation, guess an explanation for that observation, and then make a prediction that we can test with an experiment or other observation.
A couple of examples. First of all, people noticed that the Earth was below, the sky above, and both the Sun and the Moon seemed to go around them. Their guessed explanation was that the Earth must be the center of the universe. The prediction: everything should circle around the Earth. This was first really tested when Galileo got his hands on one of the first telescopes, and as he gazed into the night sky, what he found there was a planet, Jupiter, with four moons circling around it. He then used those moons to follow the path of Jupiter and found that Jupiter also was not going around the Earth but around the Sun. So the prediction test failed. And this led to the discarding of the theory that the Earth was the center of the universe.
Another example: Sir Isaac Newton noticed that things fall to the Earth. The guessed explanation was gravity, the prediction that everything should fall to the Earth. But of course, not everything does fall to the Earth. So did we discard gravity? No. We revised the theory and said, gravity pulls things to the Earth unless there is an equal and opposite force in the other direction. This led us to learn something new. We began to pay more attention to the bird and the bird's wings, and just think of all the discoveries that have flown from that line of thinking. So the test failures, the exceptions, the outliers teach us what we don't know and lead us to something new. This is how science moves forward. This is how science learns.
Sometimes in the media, and even more rarely, but sometimes even scientists will say that something or other has been scientifically proven. But I hope that you understand that science never proves anything definitively forever. Hopefully science remains curious enough to look for and humble enough to recognize when we have found the next outlier, the next exception, which, like Jupiter's moons, teaches us what we don't actually know.
We're going to change gears here for a second. The caduceus, or the symbol of medicine, means a lot of different things to different people, but most of our public discourse on medicine really turns it into an engineering problem. We have the hallways of Congress, and the boardrooms of insurance companies that try to figure out how to pay for it. The ethicists and epidemiologists try to figure out how best to distribute medicine, and the hospitals and physicians are absolutely obsessed with their protocols and checklists, trying to figure out how best to safely apply medicine. These are all good things. However, they also all assume at some level that the textbook of medicine is closed. We start to measure the quality of our health care by how quickly we can access it. It doesn't surprise me that in this climate, many of our institutions for the provision of health care start to look a heck of a lot like Jiffy Lube.
(Laughter)
The only problem is that when I graduated from medical school, I didn't get one of those little doohickeys that your mechanic has to plug into your car and find out exactly what's wrong with it, because the textbook of medicine is not closed. Medicine is science. Medicine is knowledge in process. We make an observation, we guess an explanation of that observation, and then we make a prediction that we can test. Now, the testing ground of most predictions in medicine is populations. And you may remember from those boring days in biology class that populations tend to distribute around a mean as a Gaussian or a normal curve. Therefore, in medicine, after we make a prediction from a guessed explanation, we test it in a population. That means that what we know in medicine, our knowledge and our know-how, comes from populations but extends only as far as the next outlier, the next exception, which, like Jupiter's moons, will teach us what we don't actually know.
Now, I am a surgeon who looks after patients with sarcoma. Sarcoma is a very rare form of cancer. It's the cancer of flesh and bones. And I would tell you that every one of my patients is an outlier, is an exception. There is no surgery I have ever performed for a sarcoma patient that has ever been guided by a randomized controlled clinical trial, what we consider the best kind of population-based evidence in medicine. People talk about thinking outside the box, but we don't even have a box in sarcoma. What we do have as we take a bath in the uncertainty and unknowns and exceptions and outliers that surround us in sarcoma is easy access to what I think are those two most important values for any science: humility and curiosity. Because if I am humble and curious, when a patient asks me a question, and I don't know the answer, I'll ask a colleague who may have a similar albeit distinct patient with sarcoma. We'll even establish international collaborations. Those patients will start to talk to each other through chat rooms and support groups. It's through this kind of humbly curious communication that we begin to try and learn new things.
As an example, this is a patient of mine who had a cancer near his knee. Because of humbly curious communication in international collaborations, we have learned that we can repurpose the ankle to serve as the knee when we have to remove the knee with the cancer. He can then wear a prosthetic and run and jump and play. This opportunity was available to him because of international collaborations. It was desirable to him because he had contacted other patients who had experienced it. And so exceptions and outliers in medicine teach us what we don't know, but also lead us to new thinking.
Now, very importantly, all the new thinking that outliers and exceptions lead us to in medicine does not only apply to the outliers and exceptions. It is not that we only learn from sarcoma patients ways to manage sarcoma patients. Sometimes, the outliers and the exceptions teach us things that matter quite a lot to the general population. Like a tree standing outside a forest, the outliers and the exceptions draw our attention and lead us into a much greater sense of perhaps what a tree is. We often talk about losing the forests for the trees, but one also loses a tree within a forest. But the tree that stands out by itself makes those relationships that define a tree, the relationships between trunk and roots and branches, much more apparent. Even if that tree is crooked or even if that tree has very unusual relationships between trunk and roots and branches, it nonetheless draws our attention and allows us to make observations that we can then test in the general population.
I told you that sarcomas are rare. They make up about one percent of all cancers. You also probably know that cancer is considered a genetic disease. By genetic disease we mean that cancer is caused by oncogenes that are turned on in cancer and tumor suppressor genes that are turned off to cause cancer. You might think that we learned about oncogenes and tumor suppressor genes from common cancers like breast cancer and prostate cancer and lung cancer, but you'd be wrong. We learned about oncogenes and tumor suppressor genes for the first time in that itty-bitty little one percent of cancers called sarcoma. In 1966, Peyton Rous got the Nobel Prize for realizing that chickens had a transmissible form of sarcoma. Thirty years later, Harold Varmus and Mike Bishop discovered what that transmissible element was. It was a virus carrying a gene, the src oncogene. Now, I will not tell you that src is the most important oncogene. I will not tell you that src is the most frequently turned on oncogene in all of cancer. But it was the first oncogene. The exception, the outlier drew our attention and led us to something that taught us very important things about the rest of biology.
Now, TP53 is the most important tumor suppressor gene. It is the most frequently turned off tumor suppressor gene in almost every kind of cancer. But we didn't learn about it from common cancers. We learned about it when doctors Li and Fraumeni were looking at families, and they realized that these families had way too many sarcomas. I told you that sarcoma is rare. Remember that a one in a million diagnosis, if it happens twice in one family, is way too common in that family. The very fact that these are rare draws our attention and leads us to new kinds of thinking.
Now, many of you may say, and may rightly say, that yeah, Kevin, that's great, but you're not talking about a bird's wing. You're not talking about moons floating around some planet Jupiter. This is a person. This outlier, this exception, may lead to the advancement of science, but this is a person. And all I can say is that I know that all too well. I have conversations with these patients with rare and deadly diseases. I write about these conversations. These conversations are terribly fraught. They're fraught with horrible phrases like "I have bad news" or "There's nothing more we can do." Sometimes these conversations turn on a single word: "terminal."
Silence can also be rather uncomfortable. Where the blanks are in medicine can be just as important as the words that we use in these conversations. What are the unknowns? What are the experiments that are being done?
Do this little exercise with me. Up there on the screen, you see this phrase, "no where." Notice where the blank is. If we move that blank one space over "no where" becomes "now here," the exact opposite meaning, just by shifting the blank one space over.
I'll never forget the night that I walked into one of my patients' rooms. I had been operating long that day but I still wanted to come and see him. He was a boy I had diagnosed with a bone cancer a few days before. He and his mother had been meeting with the chemotherapy doctors earlier that day, and he had been admitted to the hospital to begin chemotherapy. It was almost midnight when I got to his room. He was asleep, but I found his mother reading by flashlight next to his bed. She came out in the hall to chat with me for a few minutes. It turned out that what she had been reading was the protocol that the chemotherapy doctors had given her that day. She had memorized it. She said, "Dr. Jones, you told me that we don't always win with this type of cancer, but I've been studying this protocol, and I think I can do it. I think I can comply with these very difficult treatments. I'm going to quit my job. I'm going to move in with my parents. I'm going to keep my baby safe." I didn't tell her. I didn't stop to correct her thinking. She was trusting in a protocol that even if complied with, wouldn't necessarily save her son. I didn't tell her. I didn't fill in that blank. But a year and a half later her boy nonetheless died of his cancer. Should I have told her?
Now, many of you may say, "So what? I don't have sarcoma. No one in my family has sarcoma. And this is all fine and well, but it probably doesn't matter in my life." And you're probably right. Sarcoma may not matter a whole lot in your life. But where the blanks are in medicine does matter in your life.
I didn't tell you one dirty little secret. I told you that in medicine, we test predictions in populations, but I didn't tell you, and so often medicine never tells you that every time an individual encounters medicine, even if that individual is firmly embedded in the general population, neither the individual nor the physician knows where in that population the individual will land. Therefore, every encounter with medicine is an experiment. You will be a subject in an experiment. And the outcome will be either a better or a worse result for you. As long as medicine works well, we're fine with fast service, bravado, brimmingly confident conversations. But when things don't work well, sometimes we want something different.
A colleague of mine removed a tumor from a patient's limb. He was concerned about this tumor. In our physician conferences, he talked about his concern that this was a type of tumor that had a high risk for coming back in the same limb. But his conversations with the patient were exactly what a patient might want: brimming with confidence. He said, "I got it all and you're good to go." She and her husband were thrilled. They went out, celebrated, fancy dinner, opened a bottle of champagne. The only problem was a few weeks later, she started to notice another nodule in the same area. It turned out he hadn't gotten it all, and she wasn't good to go. But what happened at this juncture absolutely fascinates me. My colleague came to me and said, "Kevin, would you mind looking after this patient for me?" I said, "Why, you know the right thing to do as well as I do. You haven't done anything wrong." He said, "Please, just look after this patient for me." He was embarrassed -- not by what he had done, but by the conversation that he had had, by the overconfidence.
So I performed a much more invasive surgery and had a very different conversation with the patient afterwards. I said, "Most likely I've gotten it all and you're most likely good to go, but this is the experiment that we're doing. This is what you're going to watch for. This is what I'm going to watch for. And we're going to work together to find out if this surgery will work to get rid of your cancer." I can guarantee you, she and her husband did not crack another bottle of champagne after talking to me. But she was now a scientist, not only a subject in her experiment.
And so I encourage you to seek humility and curiosity in your physicians. Almost 20 billion times each year, a person walks into a doctor's office, and that person becomes a patient. You or someone you love will be that patient sometime very soon. How will you talk to your doctors? What will you tell them? What will they tell you? They cannot tell you what they do not know, but they can tell you when they don't know if only you'll ask. So please, join the conversation.
Thank you.
(Applause)
PSYCH/HEALTH/GralInt-TED Talks-Rebecca Brachman: Could a drug prevent depression and PTSD?
The following information is used for educational purposes only.
Filmed September 2016 at TEDxNewYork
Rebecca Brachman: Could a drug prevent depression and PTSD?
The path to better medicine is paved with accidental yet revolutionary discoveries. In this well-told tale of how science happens, neuroscientist Rebecca Brachman shares news of a serendipitous breakthrough treatment that may prevent mental disorders like depression and PTSD from ever developing. And listen for an unexpected — and controversial — twist.
Transcript:
This is a tuberculosis ward, and at the time this picture was taken in the late 1800s, one in seven of all people died from tuberculosis. We had no idea what was causing this disease. The hypothesis was actually it was your constitution that made you susceptible. And it was a highly romanticized disease. It was also called consumption, and it was the disorder of poets and artists and intellectuals. And some people actually thought it gave you heightened sensitivity and conferred creative genius.
By the 1950s, we instead knew that tuberculosis was caused by a highly contagious bacterial infection, which is slightly less romantic, but that had the upside of us being able to maybe develop drugs to treat it. So doctors had discovered a new drug, iproniazid, that they were optimistic might cure tuberculosis, and they gave it to patients, and patients were elated. They were more social, more energetic. One medical report actually says they were "dancing in the halls." And unfortunately, this was not necessarily because they were getting better. A lot of them were still dying. Another medical report describes them as being "inappropriately happy." And that is how the first antidepressant was discovered.
So accidental discovery is not uncommon in science, but it requires more than just a happy accident. You have to be able to recognize it for discovery to occur.
As a neuroscientist, I'm going to talk to you a little bit about my firsthand experience with whatever you want to call the opposite of dumb luck -- let's call it smart luck. But first, a bit more background.
Thankfully, since the 1950s, we've developed some other drugs and we can actually now cure tuberculosis. And at least in the United States, though not necessarily in other countries, we have closed our sanitoriums and probably most of you are not too worried about TB. But a lot of what was true in the early 1900s about infectious disease, we can say now about psychiatric disorders.
We are in the middle of an epidemic of mood disorders like depression and post-traumatic stress disorder, or PTSD. One in four of all adults in the United States suffers from mental illness, which means that if you haven't experienced it personally or someone in your family hasn't, it's still very likely that someone you know has, though they may not talk about it. Depression has actually now surpassed HIV/AIDS, malaria, diabetes and war as the leading cause of disability worldwide. And also, like tuberculosis in the 1950s, we don't know what causes it. Once it's developed, it's chronic, lasts a lifetime, and there are no known cures.
The second antidepressant we discovered, also by accident, in the 1950s, from an antihistamine that was making people manic, imipramine. And in both the case of the tuberculosis ward and the antihistamine, someone had to be able to recognize that a drug that was designed to do one thing -- treat tuberculosis or suppress allergies -- could be used to do something very different -- treat depression. And this sort of repurposing is actually quite challenging. When doctors first saw this mood-enhancing effect of iproniazid, they didn't really recognize what they saw. They were so used to thinking about it from the framework of being a tuberculosis drug that they actually just listed it as a side effect, an adverse side effect.
As you can see here, a lot of these patients in 1954 are experiencing severe euphoria. And they were worried that this might somehow interfere with their recovering from tuberculosis. So they recommended that iproniazid only be used in cases of extreme TB and in patients that were highly emotionally stable, which is of course the exact opposite of how we use it as an antidepressant. They were so used to looking at it from the perspective of this one disease, they could not see the larger implications for another disease.
And to be fair, it's not entirely their fault. Functional fixedness is a bias that affects all of us. It's a tendency to only be able to think of an object in terms of its traditional use or function. And mental set is another thing. Right? That's sort of this preconceived framework with which we approach problems. And that actually makes repurposing pretty hard for all of us, which is, I guess, why they gave a TV show to the guy who was, like, really great at repurposing.
(Laughter)
So the effects in both the case of iproniazid and imipramine, they were so strong -- there was mania, or people dancing in the halls. It's actually not that surprising they were caught. But it does make you wonder what else we've missed. So iproniazid and imipramine, they're more than just a case study in repurposing. They have two other things in common that are really important. One, they have terrible side effects. That includes liver toxicity, weight gain of over 50 pounds, suicidality. And two, they both increase levels of serotonin, which is a chemical signal in the brain, or a neurotransmitter. And those two things together, right, one or the two, may not have been that important, but the two together meant that we had to develop safer drugs, and that serotonin seemed like a pretty good place to start.
So we developed drugs to more specifically focus on serotonin, the selective serotonin reuptake inhibitors, so the SSRIs, the most famous of which is Prozac. And that was 30 years ago, and since then we have mostly just worked on optimizing those drugs. And the SSRIs, they are better than the drugs that came before them, but they still have a lot of side effects, including weight gain, insomnia, suicidality -- and they take a really long time to work, something like four to six weeks in a lot of patients. And that's in the patients where they do work. There are a lot of patients where these drugs don't work.
And that means now, in 2016, we still have no cures for any mood disorders, just drugs that suppress symptoms, which is kind of the difference between taking a painkiller for an infection versus an antibiotic. A painkiller will make you feel better, but is not going to do anything to treat that underlying disease. And it was this flexibility in our thinking that let us recognize that iproniazid and imipramine could be repurposed in this way, which led us to the serotonin hypothesis, which we then, ironically, fixated on. This is brain signaling, serotonin, from an SSRI commercial. In case you're not clear, this is a dramatization. And in science, we try and remove our bias, right, by running double-blinded experiments or being statistically agnostic as to what our results will be. But bias creeps in more insidiously in what we choose to study and how we choose to study it.
So we've focused on serotonin now for the past 30 years, often to the exclusion of other things. We still have no cures, and what if serotonin isn't all there is to depression? What if it's not even the key part of it? That means no matter how much time or money or effort we put into it, it will never lead to a cure.
In the past few years, doctors have discovered probably what is the first truly new antidepressant since the SSRIs, Calypsol, and this drug works very quickly, within a few hours or a day, and it doesn't work on serotonin. It works on glutamate, which is another neurotransmitter. And it's also repurposed. It was traditionally used as anesthesia in surgery. But unlike those other drugs, which were recognized pretty quickly, it took us 20 years to realize that Calypsol was an antidepressant, despite the fact that it's actually a better antidepressant, probably, than those other drugs. It's actually probably because of the fact that it's a better antidepressant that it was harder for us to recognize. There was no mania to signal its effects.
So in 2013, up at Columbia University, I was working with my colleague, Dr. Christine Ann Denny, and we were studying Calypsol as an antidepressant in mice. And Calypsol has, like, a really short half-life, which means it's out of your body within a few hours. And we were just piloting. So we would give an injection to mice, and then we'd wait a week, and then we'd run another experiment to save money.
And one of the experiments I was running, we would stress the mice, and we used that as a model of depression. And at first it kind of just looked like it didn't really work at all. So we could have stopped there. But I have run this model of depression for years, and the data just looked kind of weird. It didn't really look right to me. So I went back, and we reanalyzed it based on whether or not they had gotten that one injection of Calypsol a week beforehand. And it looked kind of like this. So if you look at the far left, if you put a mouse in a new space, this is the box, it's very exciting, a mouse will walk around and explore, and you can see that pink line is actually the measure of them walking. And we also give it another mouse in a pencil cup that it can decide to interact with. This is also a dramatization, in case that's not clear. And a normal mouse will explore. It will be social. Check out what's going on. If you stress a mouse in this depression model, which is the middle box, they aren't social, they don't explore. They mostly just kind of hide in that back corner, behind a cup. Yet the mice that had gotten that one injection of Calypsol, here on your right, they were exploring, they were social. They looked like they had never been stressed at all, which is impossible.
So we could have just stopped there, but Christine had also used Calypsol before as anesthesia, and a few years ago she had seen that it seemed to have some weird effects on cells and some other behavior that also seemed to last long after the drug, maybe a few weeks. So we were like, OK, maybe this is not completely impossible, but we were really skeptical.
So we did what you do in science when you're not sure, and we ran it again. And I remember being in the animal room, moving mice from box to box to test them, and Christine was actually sitting on the floor with the computer in her lap so the mice couldn't see her, and she was analyzing the data in real time. And I remember us yelling, which you're not supposed to do in an animal room where you're testing, because it had worked. It seemed like these mice were protected against stress, or they were inappropriately happy, however you want to call it. And we were really excited.
And then we were really skeptical, because it was too good to be true. So we ran it again. And then we ran it again in a PTSD model, and we ran it again in a physiological model, where all we did was give stress hormones. And we had our undergrads run it. And then we had our collaborators halfway across the world in France run it. And every time someone ran it, they confirmed the same thing. It seemed like this one injection of Calypsol was somehow protecting against stress for weeks.
And we only published this a year ago, but since then other labs have independently confirmed this effect. So we don't know what causes depression, but we do know that stress is the initial trigger in 80 percent of cases, and depression and PTSD are different diseases, but this is something they share in common. Right? It is traumatic stress like active combat or natural disasters or community violence or sexual assault that causes post-traumatic stress disorder, and not everyone that is exposed to stress develops a mood disorder. And this ability to experience stress and be resilient and bounce back and not develop depression or PTSD is known as stress resilience, and it varies between people. And we have always thought of it as just sort of this passive property. It's the absence of susceptibility factors and risk factors for these disorders. But what if it were active? Maybe we could enhance it, sort of akin to putting on armor.
We had accidentally discovered the first resilience-enhancing drug. And like I said, we only gave a tiny amount of the drug, and it lasted for weeks, and that's not like anything you see with antidepressants.
But it is actually kind of similar to what you see in immune vaccines. So in immune vaccines, you'll get your shots, and then weeks, months, years later, when you're actually exposed to bacteria, it's not the vaccine in your body that protects you. It's your own immune system that's developed resistance and resilience to this bacteria that fights it off, and you actually never get the infection, which is very different from, say, our treatments. Right? In that case, you get the infection, you're exposed to the bacteria, you're sick, and then you take, say, an antibiotic which cures it, and those drugs are actually working to kill the bacteria. Or similar to as I said before, with this palliative, you'll take something that will suppress the symptoms, but it won't treat the underlying infection, and you'll only feel better during the time in which you're taking it, which is why you have to keep taking it. And in depression and PTSD -- here we have your stress exposure -- we only have palliative care. Antidepressants only suppress symptoms, and that is why you basically have to keep taking them for the life of the disease, which is often the length of your own life.
So we're calling our resilience-enhancing drugs "paravaccines," which means vaccine-like, because it seems like they might have the potential to protect against stress and prevent mice from developing depression and post-traumatic stress disorder. Also, not all antidepressants are also paravaccines. We tried Prozac as well, and that had no effect.
So if this were to translate into humans, we might be able to protect people who are predictably at risk against stress-induced disorders like depression and PTSD. So that's first responders and firefighters, refugees, prisoners and prison guards, soldiers, you name it.
And to give you a sense of the scale of these diseases, in 2010, the global burden of disease was estimated at 2.5 trillion dollars, and since they are chronic, that cost is compounding and is therefore expected to rise up to six trillion dollars in just the next 15 years.
As I mentioned before, repurposing can be challenging because of our prior biases. Calypsol has another name, ketamine, which also goes by another name, Special K, which is a club drug and drug of abuse. It's still used across the world as an anesthetic. It's used in children. We use it on the battlefield. It's actually the drug of choice in a lot of developing nations, because it doesn't affect breathing. It is on the World Health Organization list of most essential medicines.
If we had discovered ketamine as a paravaccine first, it'd be pretty easy for us to develop it, but as is, we have to compete with our functional fixedness and mental set that kind of interfere. Fortunately, it's not the only compound we have discovered that has these prophylactic, paravaccine qualities, but all of the other drugs we've discovered, or compounds if you will, they're totally new, they have to go through the entire FDA approval process -- if they make it before they can ever be used in humans. And that will be years. So if we wanted something sooner, ketamine is already FDA-approved. It's generic, it's available. We could develop it for a fraction of the price and a fraction of the time.
But actually, beyond functional fixedness and mental set, there's a real other challenge to repurposing drugs, which is policy. There are no incentives in place once a drug is generic and off patent and no longer exclusive to encourage pharma companies to develop them, because they don't make money. And that's not true for just ketamine. That is true for all drugs. Regardless, the idea itself is completely novel in psychiatry, to use drugs to prevent mental illness as opposed to just treat it.
It is possible that 20, 50, 100 years from now, we will look back now at depression and PTSD the way we look back at tuberculosis sanitoriums as a thing of the past. This could be the beginning of the end of the mental health epidemic.
But as a great scientist once said, "Only a fool is sure of anything. A wise man keeps on guessing."
Thank you, guys.
(Applause)
Filmed September 2016 at TEDxNewYork
Rebecca Brachman: Could a drug prevent depression and PTSD?
The path to better medicine is paved with accidental yet revolutionary discoveries. In this well-told tale of how science happens, neuroscientist Rebecca Brachman shares news of a serendipitous breakthrough treatment that may prevent mental disorders like depression and PTSD from ever developing. And listen for an unexpected — and controversial — twist.
Transcript:
This is a tuberculosis ward, and at the time this picture was taken in the late 1800s, one in seven of all people died from tuberculosis. We had no idea what was causing this disease. The hypothesis was actually it was your constitution that made you susceptible. And it was a highly romanticized disease. It was also called consumption, and it was the disorder of poets and artists and intellectuals. And some people actually thought it gave you heightened sensitivity and conferred creative genius.
By the 1950s, we instead knew that tuberculosis was caused by a highly contagious bacterial infection, which is slightly less romantic, but that had the upside of us being able to maybe develop drugs to treat it. So doctors had discovered a new drug, iproniazid, that they were optimistic might cure tuberculosis, and they gave it to patients, and patients were elated. They were more social, more energetic. One medical report actually says they were "dancing in the halls." And unfortunately, this was not necessarily because they were getting better. A lot of them were still dying. Another medical report describes them as being "inappropriately happy." And that is how the first antidepressant was discovered.
So accidental discovery is not uncommon in science, but it requires more than just a happy accident. You have to be able to recognize it for discovery to occur.
As a neuroscientist, I'm going to talk to you a little bit about my firsthand experience with whatever you want to call the opposite of dumb luck -- let's call it smart luck. But first, a bit more background.
Thankfully, since the 1950s, we've developed some other drugs and we can actually now cure tuberculosis. And at least in the United States, though not necessarily in other countries, we have closed our sanitoriums and probably most of you are not too worried about TB. But a lot of what was true in the early 1900s about infectious disease, we can say now about psychiatric disorders.
We are in the middle of an epidemic of mood disorders like depression and post-traumatic stress disorder, or PTSD. One in four of all adults in the United States suffers from mental illness, which means that if you haven't experienced it personally or someone in your family hasn't, it's still very likely that someone you know has, though they may not talk about it. Depression has actually now surpassed HIV/AIDS, malaria, diabetes and war as the leading cause of disability worldwide. And also, like tuberculosis in the 1950s, we don't know what causes it. Once it's developed, it's chronic, lasts a lifetime, and there are no known cures.
The second antidepressant we discovered, also by accident, in the 1950s, from an antihistamine that was making people manic, imipramine. And in both the case of the tuberculosis ward and the antihistamine, someone had to be able to recognize that a drug that was designed to do one thing -- treat tuberculosis or suppress allergies -- could be used to do something very different -- treat depression. And this sort of repurposing is actually quite challenging. When doctors first saw this mood-enhancing effect of iproniazid, they didn't really recognize what they saw. They were so used to thinking about it from the framework of being a tuberculosis drug that they actually just listed it as a side effect, an adverse side effect.
As you can see here, a lot of these patients in 1954 are experiencing severe euphoria. And they were worried that this might somehow interfere with their recovering from tuberculosis. So they recommended that iproniazid only be used in cases of extreme TB and in patients that were highly emotionally stable, which is of course the exact opposite of how we use it as an antidepressant. They were so used to looking at it from the perspective of this one disease, they could not see the larger implications for another disease.
And to be fair, it's not entirely their fault. Functional fixedness is a bias that affects all of us. It's a tendency to only be able to think of an object in terms of its traditional use or function. And mental set is another thing. Right? That's sort of this preconceived framework with which we approach problems. And that actually makes repurposing pretty hard for all of us, which is, I guess, why they gave a TV show to the guy who was, like, really great at repurposing.
(Laughter)
So the effects in both the case of iproniazid and imipramine, they were so strong -- there was mania, or people dancing in the halls. It's actually not that surprising they were caught. But it does make you wonder what else we've missed. So iproniazid and imipramine, they're more than just a case study in repurposing. They have two other things in common that are really important. One, they have terrible side effects. That includes liver toxicity, weight gain of over 50 pounds, suicidality. And two, they both increase levels of serotonin, which is a chemical signal in the brain, or a neurotransmitter. And those two things together, right, one or the two, may not have been that important, but the two together meant that we had to develop safer drugs, and that serotonin seemed like a pretty good place to start.
So we developed drugs to more specifically focus on serotonin, the selective serotonin reuptake inhibitors, so the SSRIs, the most famous of which is Prozac. And that was 30 years ago, and since then we have mostly just worked on optimizing those drugs. And the SSRIs, they are better than the drugs that came before them, but they still have a lot of side effects, including weight gain, insomnia, suicidality -- and they take a really long time to work, something like four to six weeks in a lot of patients. And that's in the patients where they do work. There are a lot of patients where these drugs don't work.
And that means now, in 2016, we still have no cures for any mood disorders, just drugs that suppress symptoms, which is kind of the difference between taking a painkiller for an infection versus an antibiotic. A painkiller will make you feel better, but is not going to do anything to treat that underlying disease. And it was this flexibility in our thinking that let us recognize that iproniazid and imipramine could be repurposed in this way, which led us to the serotonin hypothesis, which we then, ironically, fixated on. This is brain signaling, serotonin, from an SSRI commercial. In case you're not clear, this is a dramatization. And in science, we try and remove our bias, right, by running double-blinded experiments or being statistically agnostic as to what our results will be. But bias creeps in more insidiously in what we choose to study and how we choose to study it.
So we've focused on serotonin now for the past 30 years, often to the exclusion of other things. We still have no cures, and what if serotonin isn't all there is to depression? What if it's not even the key part of it? That means no matter how much time or money or effort we put into it, it will never lead to a cure.
In the past few years, doctors have discovered probably what is the first truly new antidepressant since the SSRIs, Calypsol, and this drug works very quickly, within a few hours or a day, and it doesn't work on serotonin. It works on glutamate, which is another neurotransmitter. And it's also repurposed. It was traditionally used as anesthesia in surgery. But unlike those other drugs, which were recognized pretty quickly, it took us 20 years to realize that Calypsol was an antidepressant, despite the fact that it's actually a better antidepressant, probably, than those other drugs. It's actually probably because of the fact that it's a better antidepressant that it was harder for us to recognize. There was no mania to signal its effects.
So in 2013, up at Columbia University, I was working with my colleague, Dr. Christine Ann Denny, and we were studying Calypsol as an antidepressant in mice. And Calypsol has, like, a really short half-life, which means it's out of your body within a few hours. And we were just piloting. So we would give an injection to mice, and then we'd wait a week, and then we'd run another experiment to save money.
And one of the experiments I was running, we would stress the mice, and we used that as a model of depression. And at first it kind of just looked like it didn't really work at all. So we could have stopped there. But I have run this model of depression for years, and the data just looked kind of weird. It didn't really look right to me. So I went back, and we reanalyzed it based on whether or not they had gotten that one injection of Calypsol a week beforehand. And it looked kind of like this. So if you look at the far left, if you put a mouse in a new space, this is the box, it's very exciting, a mouse will walk around and explore, and you can see that pink line is actually the measure of them walking. And we also give it another mouse in a pencil cup that it can decide to interact with. This is also a dramatization, in case that's not clear. And a normal mouse will explore. It will be social. Check out what's going on. If you stress a mouse in this depression model, which is the middle box, they aren't social, they don't explore. They mostly just kind of hide in that back corner, behind a cup. Yet the mice that had gotten that one injection of Calypsol, here on your right, they were exploring, they were social. They looked like they had never been stressed at all, which is impossible.
So we could have just stopped there, but Christine had also used Calypsol before as anesthesia, and a few years ago she had seen that it seemed to have some weird effects on cells and some other behavior that also seemed to last long after the drug, maybe a few weeks. So we were like, OK, maybe this is not completely impossible, but we were really skeptical.
So we did what you do in science when you're not sure, and we ran it again. And I remember being in the animal room, moving mice from box to box to test them, and Christine was actually sitting on the floor with the computer in her lap so the mice couldn't see her, and she was analyzing the data in real time. And I remember us yelling, which you're not supposed to do in an animal room where you're testing, because it had worked. It seemed like these mice were protected against stress, or they were inappropriately happy, however you want to call it. And we were really excited.
And then we were really skeptical, because it was too good to be true. So we ran it again. And then we ran it again in a PTSD model, and we ran it again in a physiological model, where all we did was give stress hormones. And we had our undergrads run it. And then we had our collaborators halfway across the world in France run it. And every time someone ran it, they confirmed the same thing. It seemed like this one injection of Calypsol was somehow protecting against stress for weeks.
And we only published this a year ago, but since then other labs have independently confirmed this effect. So we don't know what causes depression, but we do know that stress is the initial trigger in 80 percent of cases, and depression and PTSD are different diseases, but this is something they share in common. Right? It is traumatic stress like active combat or natural disasters or community violence or sexual assault that causes post-traumatic stress disorder, and not everyone that is exposed to stress develops a mood disorder. And this ability to experience stress and be resilient and bounce back and not develop depression or PTSD is known as stress resilience, and it varies between people. And we have always thought of it as just sort of this passive property. It's the absence of susceptibility factors and risk factors for these disorders. But what if it were active? Maybe we could enhance it, sort of akin to putting on armor.
We had accidentally discovered the first resilience-enhancing drug. And like I said, we only gave a tiny amount of the drug, and it lasted for weeks, and that's not like anything you see with antidepressants.
But it is actually kind of similar to what you see in immune vaccines. So in immune vaccines, you'll get your shots, and then weeks, months, years later, when you're actually exposed to bacteria, it's not the vaccine in your body that protects you. It's your own immune system that's developed resistance and resilience to this bacteria that fights it off, and you actually never get the infection, which is very different from, say, our treatments. Right? In that case, you get the infection, you're exposed to the bacteria, you're sick, and then you take, say, an antibiotic which cures it, and those drugs are actually working to kill the bacteria. Or similar to as I said before, with this palliative, you'll take something that will suppress the symptoms, but it won't treat the underlying infection, and you'll only feel better during the time in which you're taking it, which is why you have to keep taking it. And in depression and PTSD -- here we have your stress exposure -- we only have palliative care. Antidepressants only suppress symptoms, and that is why you basically have to keep taking them for the life of the disease, which is often the length of your own life.
So we're calling our resilience-enhancing drugs "paravaccines," which means vaccine-like, because it seems like they might have the potential to protect against stress and prevent mice from developing depression and post-traumatic stress disorder. Also, not all antidepressants are also paravaccines. We tried Prozac as well, and that had no effect.
So if this were to translate into humans, we might be able to protect people who are predictably at risk against stress-induced disorders like depression and PTSD. So that's first responders and firefighters, refugees, prisoners and prison guards, soldiers, you name it.
And to give you a sense of the scale of these diseases, in 2010, the global burden of disease was estimated at 2.5 trillion dollars, and since they are chronic, that cost is compounding and is therefore expected to rise up to six trillion dollars in just the next 15 years.
As I mentioned before, repurposing can be challenging because of our prior biases. Calypsol has another name, ketamine, which also goes by another name, Special K, which is a club drug and drug of abuse. It's still used across the world as an anesthetic. It's used in children. We use it on the battlefield. It's actually the drug of choice in a lot of developing nations, because it doesn't affect breathing. It is on the World Health Organization list of most essential medicines.
If we had discovered ketamine as a paravaccine first, it'd be pretty easy for us to develop it, but as is, we have to compete with our functional fixedness and mental set that kind of interfere. Fortunately, it's not the only compound we have discovered that has these prophylactic, paravaccine qualities, but all of the other drugs we've discovered, or compounds if you will, they're totally new, they have to go through the entire FDA approval process -- if they make it before they can ever be used in humans. And that will be years. So if we wanted something sooner, ketamine is already FDA-approved. It's generic, it's available. We could develop it for a fraction of the price and a fraction of the time.
But actually, beyond functional fixedness and mental set, there's a real other challenge to repurposing drugs, which is policy. There are no incentives in place once a drug is generic and off patent and no longer exclusive to encourage pharma companies to develop them, because they don't make money. And that's not true for just ketamine. That is true for all drugs. Regardless, the idea itself is completely novel in psychiatry, to use drugs to prevent mental illness as opposed to just treat it.
It is possible that 20, 50, 100 years from now, we will look back now at depression and PTSD the way we look back at tuberculosis sanitoriums as a thing of the past. This could be the beginning of the end of the mental health epidemic.
But as a great scientist once said, "Only a fool is sure of anything. A wise man keeps on guessing."
Thank you, guys.
(Applause)
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