US comedian Sarah Silverman courts controversy. She’s outspoken and provocative. After performing at the technology, entertainment, and design (TED) conference I attended in California last week, she deservedly received rapturous applause from a liberal audience that days earlier had shown near-unanimous support for gay marriage.

Silverman described how she wanted to adopt a terminally ill “mentally retarded” child so s/he died before she too became old and infirm. This gag followed ones about penises and Jews. The audience demanded an encore. But TED follows a tight schedule and our plea was rejected.

And then the mood changed overnight. At dinner in the Palm Springs desert that night, two delegates told me Silverman had crossed the line by making the “retard” joke. The first was an events organiser from Washington who had not voted for Obama because of his inexperience. The second was a gay Texan with a teenage stepson who is planning to leave the US if the Republicans win next time.

Then TED curator Chris Anderson stepped in. He described her as “god awful” on Twitter and a day later “congratulated” anyone who enjoyed her slot.

Michael Arrington’s TechCrunch blog quotes an un-named delegate who praised her comic genius. It wasn’t me, but I would have done if Arrington had asked me.

I thought her edgy satire and deadpan delivery were hilarious and spent a big chunk of this evening watching clips of her on YouTube. She is like a cross between Joan Rivers, Jimmy Carr, Borat, and Bruno.

It’s easy to be tolerant of the tolerable, but as Arrington points out, Silverman was perhaps reclaiming the word “retard” in the way that queer and gay have also been reclaimed.

And strangely, I didn’t feel congratulated by Anderson for finding her funny and clever and thought-provoking and for making me feel uncomfortable at the same time.

Perhaps her cynicism appeals more to Brits, but Anderson hails from the UK and the most raucous laughter came from the New Yorker sitting next to me.

For me, a particular favourite YouTube clip of Silverman was her idea that we sell the Vatican to end world hunger and poverty.

Silverman wasn’t the only TED speaker to have a pop at the Pope. Epidemiologist and HIV activist Elizabeth Pisani doesn’t get the pontiff’s issue with condoms:

“HIV is about sex and drugs and if there are two things that make human beings irrational, they are erections and addictions…The Catholic church thinks if you give out condoms everybody is going to go out having sex. I don’t know if Pope Benedict watches TED talks but I have got news for you…I carry condoms all the time but I never get laid.”
In her wisdom of whores blog, Pisani commends her fellow TED speaker David Cameron for pledging to make policies that support prostitutes. The Tory leader used his slot to promise policies that “go with the grain of human nature” if he becomes prime minister later this year. So might this yield progressive, liberatarian measures, she wonders.

The other reason lots of the anti-Silverman TEDsters I spoke to were unimpressed at the comedian’s reference to “retards” was because her slot followed one given by autism activist Temple Grandin.

Grandin, a livestock handling expert, fears that society’s failure to “turn on” children with autism and harness their skills could prove disastrous. She said: “They are not ending up in silicon valley, where they belong…teachers don’t know what to do with these kids.”

Another chunk of the population that educators, employers and policymakers ignore at their peril are gamers, according to game designer Jane McGonigal.

Young people on average spend 10 000 hours gaming by the time they reach 21, she said, likening this to sociologist Malcolm Gladwell’s belief that this is the number of hours you need to spend at something to succeed.

Globally, 500m people spend at least an hour a day playing games. These virtuosos’ belief in the “epic win” makes them hopeful and productive individuals, she argued.

McGonigal described how, according to Herodotus, the Lydians used games to stave off an 18-year famine by distracting the hungry hordes on alternate days with dice games. The Lydians were forerunners of the Etruscans, who went on to found the Roman Empire.

As the sun set on TED 2010 and its theme of What the world needs now, perhaps the answer is after all, to quote former UK prime minister Tony Blair, “education, education, education.”

And if that applies to TED too, perhaps, as Arrington points out, the organisers should have done their homework with Silverman and watched her perform before inviting her. If they had done, they would probably found Silverman saying Obama will settle quickly into the White House as he must be used to having security guards following him around.

Silverman also shared the TED stage with Sir Ken Robinson. A year after Labour’s 1997 election victory, he led a govenment commission on education, creativity, and the economy.

Winding up the conference, he argued that life is organic, not linear, and education should be the same. He urged policy makers to ditch the idea that college is for everybody and education should follow the fast food model.

In other words, move from an industrial to an organic, agricultural system, respecting the fact that we all have different skills and grow at different rates.

If TED had a star this year, it was Jamie Oliver, the dyslexic Essex boy who has moved from TV chef to global food campaigner. Oliver wowed the conference with his passion for changing the American diet and the aftershock of his talk was still reverberating in its closing moments.

Robinson told the conference: “If you are doing something you love, an hour feels like five minutes.” I suspect the hours just whizz by for Jamie.

David Payne is editor, bmj.com, and doc2doc.bmj.com