David Payne: What the world needs now

David PayneThe woman who warned me I wouldn’t sleep was right. Even after just one day of talks about technology, entertainment and design (TED) at the Caflifornian conference of that name (What the world needs now, is this year’s theme) my head feels as it’s about to explode.

So I’m sitting hunched over my laptop on my hotel balcony at 1 am, deciding that what the world needs now is my TED Top 10 from Day 1. After that I can get some sleep. We start at 8.30 tomorrow.

1. The same woman also warned me that this conference would change my taste in music. It has, but I wasn’t prepared for it do so quite this soon. I’d been in the auditorium an hour when diminutive ukelele virtuoso Jake Shimabukuro showed up to play Schubert’s Ave Maria and Queen’s Bohemian Rhapsody on an instrument I’d hitherto associated with George Formby. I got goosebumps. I had tears in my eyes. It’s sublime. Listen to him on YouTube.

2. RCTs have revolutionised medicine by deciding which drugs do and don’t work. So why aren’t they used more often to decide social policy by removing the guesswork, asks French development economist Esther Duflo, citing a study based in 134 villages in Udaipur.

Giving mothers a kilogram of lentils if they bought their children to measles vaccination clinics boosted attendance rates by up to 38% and proved cost effective.

3. Cancer researcher William Li’s Angiogenesis Foundation has helped to educate 40 000 physicians about the theory of restoring the balance of blood vessel growth to help fight cancer. But can angiogenesis also tackle the obesity crisis, he wonders? In other words, shrinking fat by cutting off the blood supply?

4. Listening to fellow Brit Jamie Oliver lecture the Land of the Free about the health consequences of their terrible diet wasn’t always the most comfortable of experiences.

The Essex chef has taken his campaign for better school meals from England to the US and focused on Huntington, West Virginia, now the country’s second most unhealthy town.

With a TV series to plug and a TED prize to collect, Oliver emptied a wheelbarrow of sugar onto the stage to illustrate how school milk is reformulated, and what a child’s intake over five years would be, based on two bottles he or she is given each day.

Oliver’s shock tactics are familiar to UK viewers, but the audience gasped when he beamed up a slide of an oversized coffin – used by Huntington undertakers to bury the obese. He showed us teenagers with six years to live, and urged corporate America to support the First Lady’s drive to tackle child obesity.

His Long Beach audience included a fair few entrepreneurs and opinion leaders with deep pockets. This was my first true example of TED as a community of movers and shakers. They lined up to offer him access to senators, free marketing, market research, website builds, and packaging design if he wants to launch a healthy food range. He looked humbled. You don’t often see that.

5. Oliver was the second chef on the stage that day.

New York chef Dan Barber told us a tale of two farmed fish.

The taste of the first persuaded him that aquaculture can have sound credentials and enable us to enjoy fish despite collapsing natural stocks.

But a reference to them being fed on sustainable proteins made him suspicious. Nobody at the farm could explain what they were. Eventually he discovered they were the skin and bonemeal of chicken, ground into pellets.

The second fish, farmed in the south western corner of Spain in a place where 250 bird species feed, including flamingoes who fly more than 100 miles each day to feed on the farm’s shrimps.

In other words, a farm that measures its success on the health of its predators. Barber’s standing ovation followed his conclusion that the best farmers are relationship experts who encourage biodiversity and whose farms “restore rather then deplete.”

My favourite quote of the day came from black South African nuclear scientist Daphney Singo in a slot about TED’s quest to find the continent’s first Einstein: “Education is the husband that will never let  you down.”

6. Would you make your credit card statements public? Entrepreneur Philip Kaplan introduced us to the social media site blippy.com, where you upload details of what you’re buying and spending. How will your followers respond when they know you donated more than they did to Haiti? And what does a business do when everybody knows what everybody else is paying?

7. There’s a reluctance to admit the complexity of happiness, says Nobel Laureate Daniel Kahneman, and how we measure given the conflict between our two selves – remembering (in the present) and experiencing (in the past).

I was interested in Kahneman as I have the memory of an elephant and a nostalgia for the past that is not shared by my partner.

Am I also like the person he described, whose enjoyment of a symphony is “ruined” because of a screeching sound at the end? Kahneman suggests we focus too much on our remembering self, rather than our experiencing self.

Kahneman’s favourite holiday was a three-week trip to Antarctica. Would he have still taken that trip if he knew that on his return, all his photos would be destroyed and an amnesia pill would deprive him of the memory? I fear I would not not. I know my partner would.

8. Happiness matters to politicians, and David Cameron’s day was probably made when he was introduced as probably the next prime minister. In a live simulcast from London, the Tory leader’s first TED talk asked how the electorate can be made happy when a £33 trillion global debt means there’s no extra money to spend on public services.

9. “Will you be voting for that guy?” asked a fellow TEDster over lunch, clearly unimpressed, both by Cameron, and it turns out, by Thatcher too.

The talks here are great, and for someone who is programmed to report on conferences after 20 years in journalism, it’s great to put down my shorthand pad and just listen.

But my fellow delegates are fascinating too. My last blog described some of them. I’ve met more since, including a doctor treating asylum seekers and torture victims in the Bronx, dozens of entrepreneurs, a product designer, and two working alongside the real estate business whose roles I can’t quite fathom. All of them, like me, are loving TED. Many come every year.

10. I was pleased to find a lone detractor, a first-timer like me. He’s loving the talks, but finds the event a bit smug and rather like a cult.

His dining partners on the first night talked about their attendance as it they’d achieved something that went beyond jetting across America to a conference. I disagree with him, and besides, it’s too early to tell.

I slept in the end. It’s now the start of Day 2.

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