Day Two: Nutrition, Health Care of the Future, and Healing Through Music
In the April 2020 issue of Nonahood News, we provided you with a summary of the discussions from Day One of the Lake Nona Impact Forum, held on Feb. 26-28. Each year, the Lake Nona Impact Forum brings together, right here in our humble neighborhood, the nation’s leaders in the fields of health and wellness. The forum is a highly exclusive, invitation-only assembly of the best and brightest brains – and celebrity advocates – engaged in bettering our nation’s wellbeing. Nonahood News secured a
front-row seat at the forum, where we took copious notes to unlock for you the wisdom dispensed during the conference’s fast-moving discussions. For this account of the forum’s Day Two, we present to you the major ideas we heard in the order the discussions took place. Since late February, the coronavirus has dominated our lives and swept away debate and discussion about all other healthcare issues. On this Day Two of the forum, a panel featuring Brett Giroir, health and human services assistant secretary, was hastily arranged to address what was then known about the novel coronavirus. Little did we know how the virus would upend our lives only weeks later.
Let’s first set the scene. For Day Two of the Impact Forum, we moved to the Guidewell building, where the company’s CEO, Pat Geraghty, kicked off an information-packed 12 hours. If you have never visited Lake Nona’s Guidewell building, take time one day to do so. Inside, you will find a stunningly designed interior where curves and glass dominate. To visualize the Guidewell auditorium, imagine the bridge of the Starship Enterprise in a recent Star Trek film but with shapelier bends and bows. Slipping into my seat, I felt beamed forward a century or two.
For the morning’s first panel, health commentators Avik Roy and Mark McClellan, plus Pat Geraghty, considered whether 2020 could bring about major changes to healthcare. Fortune Magazine editor-in-chief Clifton Leaf moderated the session.
“Things that seem impossible rarely are – if we are determined to achieve them,” declared Roy, a respected commentator on health issues and a fierce optimist that our national healthcare system can be fixed. Roy offered a description of the Swiss healthcare system, which in his view is an ideal model for the United States. Many Americans, he said, grouse that our government should not seek to subsidize healthcare. But the United States already does so, much more in fact than other advanced countries. Switzerland, for example, subsidizes healthcare at only ¼ the rate of the United States. Through policies that serve to underpin private insurers, Switzerland, said Roy, offers its citizens a healthcare infrastructure that is personalized, fair to taxpayers, affordable for all generations, and promotes both innovation and competition. What could the United States do to work toward such a system? Roy pointed to four necessary steps: build on individual insurance; reduce prices, particularly for drugs; reform Medicaid and Medicare; and pursue additional measures, such as restraining the monopoly power that hospitals exercise. Properly reforming the U.S. healthcare system, Roy cautioned, could nevertheless take decades.
As we press for healthcare reform, Pat Geraghty observed, social determinants must be taken into account. Polls regularly show, for example, that Americans have no appetite for paying higher taxes for Medicare For All. While it is vital to attack costs and resolve “surprise billings,” other major issues require solutions, such as how to contain costs for complex medical procedures. In the meantime, Geraghty contends, our healthcare policies remain stuck trying to solve “yesterday’s issues.” Winding up the panel, Mark McClellan remarked that Germans routinely express shock that the U.S. Congress takes on healthcare reform only once a decade. German legislators, in contrast, enact incremental adjustments to healthcare law annually, a practice that McClellan calls on the U.S. Congress to emulate.
In a session on “Cancer Game Changers,” FDA Commissioner Amy Abernethy, Tempus CEO Eric Lefkofsky, and Howard Burris of the Sarah Cannon Research Institute discussed the stubborn difficulties in reforming the federal regulatory pathways so that they are adequately adapted to fast-paced advances in cancer drugs and treatments. Molecular data that ignores the conditions for individual patients, the panelists argued, will not provide the solutions sought. Instead, we must commit to developing and deploying big data for use by providers and patients, that is, data accompanied by individualized drugs and treatments that target each patient’s medical specificities. In the near term, policymakers will need to “think differently” and recognize that big data and individualized cancer treatments will require new approaches to regulation.
Next, a quintet of experts offered predictions for what our “Healthcare of the Future” might look like, suggesting innovative concepts that we might soon see in clinics and hospitals. Among these are remote surgery and treatments, “virtual visits” to healthcare providers, and the use of patients’ holographs or “digital twins” with diagnoses aided by artificial intelligence. These innovations would be fueled by flows of big data. We already possess sufficient data, “tons of data,” in fact; the problem is that the data are not delivered to healthcare providers in a usable and timely fashion. Our reliance on fee-for-service and the fragmented nature of our national healthcare system further complicate the effective deployment of big data.
Sandro Galea, dean of Boston University’s School of Public Health, rose to speak on “redesigning health and wellbeing” in a passionately delivered presentation recapping the many proposals found in his book Well, copies of which were supplied to forum participants. In Well, Galea asks that we not talk about healthcare but rather about health, since health “is defined by the full spectrum of our life circumstances, from … where we live to the people we see and the choices we make. And unless we understand those forces, our health is never going to improve.” In contrast to our current views toward healthcare, health should be seen as a public good. We will not be able to provide good health for the many, contends Galea, if we exclude the few, which means that compassion coupled with wisdom must find a place at the heart of our thinking about health.
On Feb. 27, this Day Two of the Impact Forum, only 60 cases of COVID-19 had been confirmed in the United States. But it was already clear that the virus would spread nationwide, even if we were innocent about the scale the pandemic would assume. Coronavirus had not been included in the conference program, so forum organizers quickly arranged a panel discussion featuring Brett Giroir and Jonathan Perlin, chief medical officer of HCA Healthcare, to address the possible impact of the virus. Giroir said that in the United States, we have been “preparing for a pandemic since 2009, and even before that, so health systems around the country will be looking at how we can potentially make sure that patients who are infected don’t infect people who are not infected.” So little did we know about this virus just weeks before our country shut down. In March and April, Giroir stood frequently next to Anthony Fauci and Deborah Birx at White House press conferences to answer questions about nationwide coronavirus testing, his new responsibility. In these briefings, Giroir projected real competence.
Two panels ensued, both moderated by Alan Murray of Fortune Media, which took on the topic of health in the workplace. According to Bank of America CEO Brian Moynihan, one in five adult Americans is apt to show some degree of mental illness at work. Managers should be trained to spot at-risk employees and take needed action since employees themselves often do not seek treatment. Taking care of these employees is the “right thing to do and good for business,” argues Moynihan. Garen Staglin, the CEO of One Mind, a nonprofit focused on mental health issues, cited the challenges employers face in dealing with at-risk employees. We should first seek to remove the stigma that typically accompanies breaches in mental health while fostering a caring environment where barriers to access care are lowered. The brain, insists Staglin, is just another organ of the body, like the heart or liver, that requires proper care. Lapses in mental health often result from physiological anomalies in that organ.
For the next session, several commentators crowded onto the Guidewell stage to trade ideas about “Innovative Approaches to Wellbeing.” In an effort to bring health and wellbeing to the hospitality business, CEO of Hyatt Hotels Mark Hoplamazian announced that his firm had introduced mindfulness training for thousands of its employees. During the training, employees are prodded to ask themselves, “What is my happiness quotient today?” CEOs of large corporations, suggested Hoplamazian, are “leaning into holistic health,” but it is too early to demonstrate whether this effort can reduce costs in the hospitality business.
Lunch hour arrived. At last, mumbled your Nonahood News reporter. My head was throbbing. I strongly sensed that the organ inside my skull, AKA my brain, would refuse to accept any more data without a pause for nutritional – and mental – refreshment. In contrast, the workaholic overachievers attending the Lake Nona Impact Forum showed no need to rest their brains. During the one hour and 20 minutes allotted for lunch, attendees were prodded to join one of 10 “roundtables” on such issues as precision pharmacology, gene editing, 5G in healthcare, Rx exercise, and music for healing. I demurred and directed my steps to the buffet line in the lobby.
Following a healthy and tasty lunch, a capacity crowd packed the Guidewell auditorium for Brooke Shields, who had been pegged to speak on an agenda item cryptically entitled “Personal Journeys in Mental Health.” As Shields stepped on stage, the audience lit into cheers, her vivacious yet regal bearing electrifying the crowd. This is a woman in her mid-50s who radiates a rare youthful beauty, effortlessly shedding 20 years from her actual age. As she spoke, what struck home was how she so easily took on such a deeply personal, heart-rending topic with such raw but good-natured honesty: her life-threatening episode of postpartum depression following the birth of her first child, Rowan Francis. As a new mother, her emotional pain at times was so great that, while driving, she would be overcome with an urge to slam her car into the next wall just to end her misery. This was serious stuff.
Interviewing Shields was Daryl Tol of AdventHealth, who maintained a subdued tone, which allowed Shields to project a clear and candid account of her trauma as a new mother. Unaware of the source of her condition and in denial that she suffered from any medical illness, Shields had determined to “power through” her bouts of depression as she had done facing earlier life challenges. Was she afraid of public shaming if she openly acknowledged her depression? “No,” replied Shields, “I have lived my whole life in public, even down to the day I lost my virginity, so what others thought did not bother me.” What she did fear, however, was failure, which led her to avoid doctors and medications as her depression took hold. In time, she came to recognize that she could find strength in asking for help and accepted her diagnosis of extreme postpartum depression and the necessary medications (which, as Shields relates, she briefly – and foolishly – stopped taking before realizing her error). In recovery, Shields penned a book about her experience, Down Came the Rain. She did not wish this to be another “poor me” book but rather sought to provide guidance and comfort to women suffering from postpartum depression by describing in detail her own experience.
I concede that I had never taken Brooke Shields seriously (though I knew she held a degree from Princeton, an achievement she pointed to with genuine pride during the Impact Forum). After hearing her speak in person, I am a seriously dedicated fan.
The forum shifted to a calmer tone as the internationally-acclaimed soprano star Renée Fleming took the stage to lead a session on the “Healing Impact of Music” in the company of composer and MIT professor Tod Machover, Emmeline Edwards of the National Center for Complementary and Integrative Health, and former Talking Heads keyboardist Jerry Harrison. (Earlier in the day, the soft-spoken Harrison had briefly described for the audience his founding of Red Crow, an innovative mixed profit/nonprofit organization aimed at combating snakebites. Snakes, said Harrison, are the third most deadly living creatures after mosquitoes and humans.)
If you could identify a theme for this year’s forum, it would most likely be constructing a connection between music and health. Renée Fleming’s panel introduced us to the mind-bogglingly inventive work in this field pursued by Tod Machover at MIT’s Media Lab. Among Machover’s accomplishments is the manufacture of personalized musical instruments that react to and amplify the expression of the musicians who play them. One of these instruments belongs to a cerebral palsy patient named Dan Ellsey, the star of a Ted Talk video Machover urged us to view. Through a device programmed specifically to record his movements, Ellsey is able to create and perform his own musical compositions, which resemble intricate mini-symphonies. Convinced of the therapeutic value of music, Machover calls on us to think of music as medicine. Through the use of music, he contends, non-invasive therapies can be developed to enhance the cognitive abilities of individuals with Alzheimer’s, cerebral palsy, and other illnesses affecting the health of the brain.
The following session addressed nutrition, “our single biggest health issue,” according to Dariush Mozaffarian, the dean of Tuft University’s School of Nutrition Science. The American public “gets” the obesity issue but does not know what to do to combat the scourge. Americans, in fact, are confused about what they should eat in the first place. For Mozaffarian, the villains are starch and sugar. In the processed foods that we purchase, he says we are actually eating predigested meals, which strip away most beneficial calories, leaving behind only glucose and starch. Mozaffarian is sometimes asked, “Should I spread cream cheese on my bagel?” “Don’t even eat the bagel,” he replies.
Sharing the stage for this session was Montel Williams of TV talk show renown. In 1999, Williams was diagnosed with multiple sclerosis. In a desperate search for effective treatments, Williams consulted the “best doctors in the world,” none of whom, he recalls, would suggest changes in his nutritional habits to combine with his medical treatments. A frustrated Williams set about to teach himself about nutrition to help him fight the inflammation that accompanied his illness. By switching to a mainly plant-based diet, he successfully lessened many of his symptoms. “We live in a quick-fix world,” says Williams, “and the food industry is making money feeding us poison.” Until we make our government, and in particular our elected officials, accountable for the nutrition crisis, “all bets are off” that we will make progress in improving nutrition in this country.
Health and Human Services Assistant Secretary Brett Giroir took the floor next with Patrice Harris, the president of the American Medical Association, to update us on the struggle to contain our national opioid epidemic. Since 1998, nearly a million Americans have died from opioid abuse as the drugs of choice have shifted from opioid medications to heroin and more recently to fentanyl and meth. Even if last year we witnessed a tiny glimmer of hope in a 4% reduction in opioid deaths, a concerted effort by our entire society is needed to attack and solve the crisis. “If you have no community, you are not going to recover,” stressed Giroir. Conquering opioid addiction will require a broad array of interventions, including education of healthcare professionals, private-public collaboration, and prevention and recovery programs.
Day Two ended with a lively discussion on “Limitless Minds,” where Seattle Seahawks star quarterback Russell Wilson spoke of his lifetime quest for credible answers to the question of why winners win. From a young age, Wilson has been obsessed with how workings of the mind impact athletic performance. “When sports stars have a ball in their hands, they change,” says Wilson. But when they fall into tough spots, athletes have traditionally turned to “positive thinking,” where an overload of emotion can veil the true situation they face and available avenues for success. By applying “neutral thinking,” a sort of meditation on the move, athletes can accept the reality of their situation and focus intently on their next move. (Wilson’s ideas recalled remarks made earlier in the day by Deepak Chopra, who referred to the paths available for reaching a higher state of awareness described in his recent book, Metahuman.) “Greatness comes through adversity,” says Wilson, “and if you truly want to be great, your lifestyle cannot be random.” Neutral thinking allows you to focus on behaviors, not outcomes. Could the technique of neutral thinking apply outside of sports? Certainly, argues Wilson, who proposes that business leaders, for example, could benefit from the application of neutral thinking.
This intriguing concept linking sports and wellness capped off Day Two of the forum. We had spent an exhilarating day absorbing nonstop information about innovations in health and wellness and their links to music, nutrition, consciousness – and, in the case of one major celebrity, honesty. We looked forward with excitement to Day Three.
In next month’s issue – Day Three of the 2020 Lake Nona Impact Forum: Genes, Movement, and “Never Alone”
Photos Courtesy of the 2020 Lake Nona Impact Forum
