Eric Dishman: Health care should be a team sport

Translator: Joseph Geni Reviewer: Morton Bast

Translator: Sara Soto Reviewer: Servizo de Normalización Lingüística

Quero compartir con vós algunhas historias e amizades

das que nunca antes falei en público

para ilustrar a idea, a necesidade e a esperanza

I want to share some personal friends and stories with you

de reinventar o actual sistema sanitario en todo o mundo.

that I've actually never talked about in public before

Hai 24 anos, no segundo ano da universidade,

to help illustrate the idea

and the need and the hope

tiven uns desmaios que non tiñan que ver co alcohol.

for us to reinvent our health care system around the world.

Acabei no centro de saúde estudantil,

Twenty-four years ago, I had -- a sophomore in college,

fixéronme unhas análises, volveron e dixéronme: “Problemas renais”.

I had a series of fainting spells. No alcohol was involved.

De súpeto, vinme inmerso

And I ended up in student health,

and they ran some labwork and came back right away,

en seis meses de probas, ensaios e tribulacións

and said, "Kidney problems."

con seis doutores en dous hospitais nun duelo de titáns médicos

And before I knew it, I was involved and thrown into

this six months of tests and trials and tribulations

para descubrir quen tiña razón sobre o que padecía.

with six doctors across two hospitals

Tempo despois, mentres esperaba na sala a ecografía,

in this clash of medical titans

os 6 médicos aparecen á vez na sala e penso: “Ai, non. Son malas novas”.

to figure out which one of them was right

about what was wrong with me.

And I'm sitting in a waiting room some time later for an ultrasound,

O diagnóstico foi o seguinte:

and all six of these doctors actually show up in the room at once,

“Tes dúas enfermidades renais raras

and I'm like, "Uh oh, this is bad news."

que, co tempo, acabarán destruíndo os teus riles.

Tes células canceríxenas no teu sistema inmunitario

And their diagnosis was this:

que temos que comezar a tratar xa.

They said, "You have two rare kidney diseases

Non es apto para un transplante de riles, nin vivirás máis de 2 ou 3 anos”.

that are going to actually destroy your kidneys eventually,

you have cancer-like cells in your immune system

that we need to start treatment right away,

A gravidade deste desalentador diagnóstico absorbeume de inmediato,

and you'll never be eligible for a kidney transplant,

and you're not likely to live more than two or three years."

como se comezase a prepararme como paciente

Now, with the gravity of this doomsday diagnosis,

para morrer segundo o calendario que me acababan de dar.

it just sucked me in immediately,

Ata que coñecín na sala unha paciente chamada Verna,

as if I began preparing myself as a patient

que pasou a ser unha grande amiga. Un día levoume á biblioteca médica

to die according to the schedule that they had just given to me,

e fixo moitas pescudas sobre estes diagnósticos e enfermidades

until I met a patient named Verna in a waiting room,

e díxome: “Eric, a xente que ten isto adoita ter 70 ou 80 anos.

who became a dear friend, and she grabbed me one day

and took me off to the medical library

Non saben nada de ti. Esperta.

and did a bunch of research on these diagnoses and these diseases,

Toma o control da túa saúde e continúa coa túa vida”.

and said, "Eric, these people who get this

E iso fixen.

are normally in their '70s and '80s.

They don't know anything about you. Wake up.

As persoas que me deron ese diagnóstico non eran malas.

Take control of your health and get on with your life."

De feito, eses profesionais facían milagres,

pero traballan nun sistema defectuoso, caro e mal configurado.

And I did.

Now, these people making these proclamations to me

Depende de hospitais e clínicas para as nosas necesidades sanitarias.

were not bad people.

In fact, these professionals were miracle workers,

but they're working in a flawed, expensive system that's set up the wrong way.

Depende de especialistas que só examinan certas partes de nós.

Depende de conxecturas sobre diagnósticos e cócteles de medicamentos,

It's dependent on hospitals and clinics for our every care need.

polo que ou funciona ou morres.

It's dependent on specialists who just look at parts of us.

Depende de pacientes pasivos que o aceptan sen facer preguntas.

It's dependent on guesswork of diagnoses and drug cocktails,

and so something either works or you die.

O problema con este modelo

And it's dependent on passive patients

é que é insostible e inaccesible globalmente.

who just take it and don't ask any questions.

Temos que inventar o que eu chamo un “sistema de saúde persoal”.

Now the problem with this model

Entón, como será este sistema de saúde persoal?

is that it's unsustainable globally.

It's unaffordable globally.

Que novas tecnoloxías e funcións suporá?

We need to invent what I call a personal health system.

Comezarei presentándovos a miña nova amiga, Libby,

So what does this personal health system look like,

and what new technologies and roles is it going to entail?

con quen me encariñei bastante nos últimos 6 meses.

Esta é Libby ou, máis ben, é a ecografía de Libby.

Now, I'm going to start by actually sharing with you

a new friend of mine, Libby,

Este é o transplante de ril que se supoñía que nunca ía ter.

somebody I've become quite attached to over the last six months.

Esta é unha imaxe de hai un par de semanas para hoxe

This is Libby, or actually, this is an ultrasound image of Libby.

e darédesvos conta de que no bordo

This is the kidney transplant I was never supposed to have.

hai unhas manchas escuras que me preocuparon moito.

Now, this is an image that we shot a couple of weeks ago for today,

Imos facer un exame en directo para ver como está Libby.

and you'll notice, on the edge of this image,

Non é un erro de vestiario, teño que quitarme o cinto.

there's some dark spots there, which was really concerning to me.

Non vos preocupedes os da primeira fila.

So we're going to actually do a live exam

(Risas)

Usarei o dispositivo da empresa Mobisante.

to sort of see how Libby's doing.

This is not a wardrobe malfunction. I have to take my belt off here.

Trátase dun ecógrafo portátil que podo conectar a un móbil ou tableta.

Don't you in the front row worry or anything.

(Laughter)

Mobisante está en Redmond, Washington, e formáronme para manexalo.

I'm going to use a device from a company called Mobisante.

This is a portable ultrasound.

It can plug into a smartphone. It can plug into a tablet.

Os pacientes non están autorizados para facelo.

Esta é unha demostración conceptual.

Mobisante is up in Redmond, Washington,

and they kindly trained me to actually do this on myself.

Ben, vou pór o xel.

Agora os da primeira fila están moi nerviosos.

(Risas)

They're not approved to do this. Patients are not approved to do this.

This is a concept demo, so I want to make that clear.

Tamén quero presentarvos o Dr. Batiuk, outro amigo meu.

All right, I gotta gel up.

Now the people in the front row are very nervous. (Laughter)

Está no Legacy Good Samaritan Hospital de Portland, en Oregón.

And I want to actually introduce you to Dr. Batiuk,

Deixádeme asegurarme. Ola, Dr. Batiuk, escóitasme ben?

who's another friend of mine.

E podes ver a Libby?

He's up in Legacy Good Samaritan Hospital in Portland, Oregon.

Thomas Batiuk: Ola, Eric. Véxote ocupado. Que tal?

Eric Dishman: Ben, estou quitando a roupa

So let me just make sure. Hey, Dr. Batiuk. Can you hear me okay?

diante de centos de persoas. É marabilloso.

And actually, can you see Libby?

Thomas Batuik: Hi there, Eric.

Só quería ver se esta é a imaxe que necesitas.

You look busy. How are you?

Eric Dishman: I'm good. I'm just taking my clothes off

Sei que queres observar se as manchas seguen aquí.

in front of a few hundred people. It's wonderful.

So I just wanted to see, is this the image you need to get?

TB: Imos escanear un pouco por aí. Móstrame a zona.

ED: De acordo. TB: Vale, xírao un pouco cara a dentro,

And I know you want to look and see if those spots are still there.

TB: Okay. Well let's scan around a little bit here,

un pouco cara ao medio.

Vale, está ben, que tal un pouco máis arriba?

give me a lay of the land.

ED: All right.TB: Okay. Turn it a little bit inside,

Conxela esa imaxe. Esa váleme.

a little bit toward the middle for me.

Okay, that's good. How about up a little bit?

ED: De acordo. Cando fixen isto a semana pasada

dixéchesme que medise a mancha dereita.

Okay, freeze that image. That's a good one for me.

Fágoo de novo?

TB: Si, faino.

ED: All right. Now last week, when I did this,

ED: Isto é un pouco difícil

you had me measure that spot to the right.

cunha man no abdome e a outra medindo, pero creo que está.

Should I do that again?

TB: Yeah, let's do that.

Vou gardar a imaxe e enviarcha.

ED: All right. This is kind of hard to do

Cóntame un pouco que significa esta mancha escura.

with one hand on your belly and one hand on measuring,

Non é algo do que me alegrase moito.

but I've got it, I think,

TB: Despois dun transplante de ril,

and I'll save that image and send it to you.

moita xente acumula líquido ao redor deste.

So tell me a little bit about what this dark spot means.

A maioría das veces non é daniño, pero é necesario examinalo.

It's not something I was very happy about.

TB: Many people after a kidney transplant

will develop a little fluid collection around the kidney.

Por iso me alegro de poder facelo hoxe,

Most of the time it doesn't create any kind of mischief,

asegurarnos de que non crece e que non crea ningún problema.

Tendo en conta as outras imaxes, estou moi contento co aspecto actual.

but it does warrant looking at,

so I'm happy we've got an opportunity to look at it today,

ED: Supoño que o volveremos revisar cando vaia.

make sure that it's not growing, it's not creating any problems.

Teño a biopsia semestral nun par de semanas

Based on the other images we have,

e deixarei que ma fagan na clínica, porque eu non creo que mo poida facer.

I'm really happy how it looks today.

ED: All right. Well, I guess we'll double check it when I come in.

TB: Ben pensado. ED: Grazas, Dr. Batiuk.

I've got my six month biopsy in a couple of weeks,

O que estades a ver aquí é un exemplo de tecnoloxía disruptiva,

and I'm going to let you do that in the clinic,

because I don't think I can do that one on myself.

de tecnoloxía móbil, social e analítica.

TB: Good choice.ED: All right, thanks, Dr. Batiuk.

Estas son as bases do que fará posible a saúde persoal.

All right. So what you're sort of seeing here

is an example of disruptive technologies,

Existen tres piares desta saúde persoal dos que quero falarvos:

of mobile, social and analytic technologies.

a atención ubicua, en rede e a personalizada.

These are the foundations of what's going to make personal health possible.

Vistes un pouco das primeiras dúas na miña interacción co Dr. Batiuk.

Now there's really three pillars

of this personal health I want to talk to you about now,

Comecemos, logo, coa atención ubicua.

and it's care anywhere, care networking and care customization.

Na década de 1780, os humanos inventamos a idea de hospitais e clínicas.

And you just saw a little bit of the first two

with my interaction with Dr. Batiuk.

É momento de poñernos ao día.

So let's start with care anywhere.

Temos que liberar os médicos e pacientes

Humans invented the idea of hospitals and clinics

da idea de viaxar a un lugar físico para atender os nosos coidados,

in the 1780s. It is time to update our thinking.

We have got to untether clinicians and patients

porque adoitan ser a ferramenta incorrecta e a máis cara para o traballo.

from the notion of traveling to a special

Ás veces son lugares perigosos para enviar os pacientes máis enfermos,

bricks-and-mortar place for all of our care,

because these places are often the wrong tool,

sobre todo nunha época de superbacterias e de infeccións contraídas nos hospitais.

and the most expensive tool, for the job.

Moitos países van quedar de brazos cruzados desde o principio

And these are sometimes unsafe places to send our sickest patients,

porque nunca van poder financiar

especially in an era of superbugs

os megacomplexos médicos que construíu o resto do mundo.

and hospital-acquired infections.

And many countries are going to go brickless from the start

Aprendín de primeira man

because they're never going to be able to afford

que os hospitais poden ser moi perigosos a unha idade temperá.

the mega-medicalplexes that a lot of the rest of the world has built.

Este son eu en 3º de primaria.

Tiven unha rotura grave no cóbado; tivéronme que operar

Now I personally learned that hospitals

e preocupábame por se ía perder o brazo.

can be a very dangerous place at a young age.

Mentres me recuperaba da operación no hospital saíronme éscaras.

This was me in third grade.

I broke my elbow very seriously, had to have surgery,

Acabáronse infectando

e déronme un antibiótico ao que era alérxico.

worried that they were going to actually lose the arm.

Recovering from the surgery in the hospital, I get bedsores.

Todo o meu corpo descompúxose e infectouse.

Those bedsores become infected,

Canto máis tempo quedaba no hospital, máis enfermo estaba e máis caro era.

and they give me an antibiotic which I end up being allergic to,

and now my whole body breaks out,

Isto ocórrelle a millóns de persoas do mundo cada ano.

and now all of those become infected.

O futuro da saúde persoal da que estou falando

The longer I stayed in the hospital, the sicker I became,

sostén que o coidado debe darse na casa como algo implícito,

and the more expensive it became,

and this happens to millions of people around the world every year.

non no hospital ou na clínica.

The future of personal health that I'm talking about

Tedes que ganar o sitio estando bastante enfermos

says care must occur at home as the default model,

Hoxe, os teléfonos intelixentes que usamos poden ter conectados

not in a hospital or clinic.

You have to earn your way into those places

dispositivos de diagnóstico como ecógrafos e moitos outros tipos máis.

by being sick enough to use that tool for the job.

Cos sensores incorporados,

Now the smartphones that we're already carrying

poderemos controlar as constantes vitais e os comportamentos como nunca antes.

can clearly have diagnostic devices like ultrasounds plugged into them,

and a whole array of others, today,

Moitos teremos implantados dispositivos que analizarán en tempo real

and as sensing is built into these,

we'll be able to do vital signs monitor

o que pasa coa nosa química sanguínea e as nosas proteínas.

and behavioral monitoring like we've never had before.

Hoxe, o soporte lóxico faise máis intelixente, non?

Many of us will have implantables that will actually look

Pensade nun adestrador, nun axente en liña,

real-time at what's going on with our blood chemistry

and in our proteins right now.

que me axudará a coidarme de forma seguro.

Esa mesma interacción coa ecografía pode que teña

Now the software is also getting smarter, right?

Think about a coach, an agent online,

un procesador de imaxe en tempo real e o dispositivo dirá: “Arriba, dereita,

that's going to help me do safe self-care.

Eric, ese é o punto perfecto para enviarlle a imaxe ao teu doutor”.

That same interaction that we just did with the ultrasound

will likely have real-time image processing,

Se temos todos estes dispositivos na rede

and the device will say, "Up, down, left, right,

que nos axudan á atención ubicua,

ah, Eric, that's the perfect spot to send that image

é lóxico pensar que necesitamos un equipo capaz de interactuar con todo isto,

off to your doctor."

Now, if we've got all these networked devices

o cal nos leva ao segundo piar do que quero falar: a atención na rede.

that are helping us to do care anywhere,

it stands to reason that we also need a team

Temos que superar este paradigma

to be able to interact with all of that stuff,

de especialistas illados que atenden só unha parte

and that leads to the second pillar I want to talk about,

care networking.

e pasar a equipos multidisciplinarios que atendan a unha persoa.

We have got to go beyond this paradigm

of isolated specialists doing parts care

Hoxe, o coidado descoordinado é caro no mellor dos casos

e letal no peor.

to multidisciplinary teams doing person care.

O 80 % dos erros médicos

prodúcense por problemas de comunicación e coordinación

Uncoordinated care today is expensive at best,

entre o equipo médico.

and it is deadly at worst.

Hai anos deume un susto o corazón na escola de posgrao

Eighty percent of medical errors are actually caused

cando estaba en tratamento para o ril.

by communication and coordination problems

Dixéronme: “Cremos que tes un problema de corazón”.

amongst medical team members.

Tiña palpitacións.

I had my own heart scare years ago in graduate school,

Sometéronme a cinco semanas de probas moi caras e aterrecedoras

when we're under treatment for the kidney,

and suddenly, they're like, "Oh, we think you have a heart problem."

antes de que a enfermeira se decatase da miña lista de medicamentos

And I have these palpitations that are showing up.

They put me through five weeks of tests --

que levaba a todas as consultas e exclamou: “Meu Deus!”.

very expensive, very scary -- before the nurse finally notices

Tres especialistas diferentes receitáronme tres versións diferentes do mesmo fármaco.

the piece of the paper, my meds list

that I've been carrying to every single appointment,

Non tiña un problema cardíaco, senón de sobredose.

and says, "Oh my gosh."

Three different specialists had prescribed

Tiña un problema de coordinación médica.

three different versions of the same drug to me.

Isto ocórrelles a millóns de persoas cada ano.

I did not have a heart problem. I had an overdose problem.

Quero usar a tecnoloxía na que traballamos e que facemos realidade

I had a care coordination problem.

para converter a atención sanitaria nun deporte de equipo.

And this happens to millions of people every year.

Agora, isto é o que máis me aterra.

I want to use technology that we're all working on and making happen

Á parte de toda a atención que tiven nos hospitais e clínicas de todo o mundo,

to make health care a coordinated team sport.

a primeira vez que experimentei a atención baseada no equipo

Now this is the most frightening thing to me.

foi estes últimos seis meses no Legacy Good Sam.

Out of all the care I've had in hospitals and clinics around the world,

Velaí a foto da graduación do meu equipo do Good Sam.

the first time I've ever had a true team-based care experience

Hai varias persoas aquí. Recoñeceredes ao Dr. Batiuk.

was at Legacy Good Sam these last six months

Acabamos de falar con el. Esta é Jenny, unha enfermeira;

for me to go get this.

And this is a picture of my graduation team from Legacy.

Allison, que manexou a lista de transplantes

e unha ducia máis que non aparecen:

There's a couple of the folks here. You'll recognize Dr. Batiuk.

o farmacéutico, o psicólogo, o nutricionista

We just talked to him. Here's Jenny, one of the nurses,

e incluso Lisa, a asesora financeira,

Allison, who helped manage the transplant list,

que nos axudou a xestionar uns problemas co seguro.

and a dozen other people who aren't pictured,

Chorei o día que me graduei.

a pharmacist, a psychologist, a nutritionist,

Debería estar feliz porque podía volver cos meus doutores,

even a financial counselor, Lisa,

who helped us deal with all the insurance hassles.

pero chorei porque conectei moito con este equipo.

I wept the day I graduated.

Velaquí a parte máis importante.

As outras persoas da foto somos a miña muller Ashley e mais eu.

I should have been happy, because I was so well

that I could go back to my normal doctors,

but I wept because I was so actually connected to this team.

Good Sam ensinounos como coidarme na casa

And here's the most important part.

para quitar cargaaos hospitais e clínicas.

The other people in this picture are me and my wife, Ashley.

Esa é a única maneira de que o modelo funcione.

Legacy trained us on how to do care for me at home

O meu equipo está traballando en China nun destes modelos de autocoidado

so that they could offload the hospitals and clinics.

para o proxecto “Cidades anciamigables”.

That's the only way that the model works.

Tentamos crear unha rede social

My team is actually working in China

que poida facer un rastrexo e formar os maiores

on one of these self-care models

que se coidan a si mesmos,

for a project we called Age-Friendly Cities.

pero tamén os familiares que os coidan

We're trying to help build a social network

ou os sanitarios voluntarios da comunidade,

that can help track and train the care of seniors

así como crear unha rede de intercambio en liña

caring for themselves

para que, por exemplo, poida doar 3 horas de coidados ao día á túa nai,

as well as the care provided by their family members

or volunteer community health workers,

ou se alguén pode axudarme co transporte das comidas,

as well as have an exchange network online,

e intercambiamos todo iso en liña.

where, for example, I can donate three hours of care a day to your mom,

O máis importante que quero dicirvos sobre isto

if somebody else can help me with transportation to meals,

é que a sagrada e idealizada relación

and we exchange all of that online.

entre o doutor e o paciente é unha reliquia do pasado.

The most important point I want to make to you about this

is the sacred and somewhat over-romanticized

O futuro da atención médica son os equipos intelixentes

e deberiades estar nese equipo por vós mesmos.

doctor-patient one-on-one

is a relic of the past.

O último do que quero falarvos é a atención personalizada,

The future of health care is smart teams,

porque se se ten atención ubicua e atención na rede,

and you'd better be on that team for yourself.

contribuirase moito á mellora do noso sistema sanitario,

Now, the last thing that I want to talk to you about

pero segue habendo demasiadas conxecturas.

is care customization,

because if you've got care anywhere and you've got care networking,

As probas clínicas aleatorizadas inventáronse en 1948

those are going to go a long way towards improving our health care system,

para axudar a crear os fármacos que curaban a tuberculose.

but there's still too much guesswork.

Iso é importante, non digo o contrario.

Randomized clinical trials were actually invented in 1948

Eses estudos de poboación que fixemos

crearon moitos fármacos que salvaron millóns de vidas.

to help invent the drugs that cured tuberculosis,

Pero o problema é que a sanidade

and those are important things, don't get me wrong.

nos trata como unha media, non coma individuos únicos,

These population studies that we've done have created

tons of miracle drugs that have saved millions of lives,

porque, á fin e ao cabo,

but the problem is that health care

non é o mesmo o paciente que a poboación estudada.

is treating us as averages, not unique individuals,

Iso é o que leva ás conxecturas.

As tecnoloxías que están a chegar,

because at the end of the day,

the patient is not the same thing as the population

a informática de alto rendemento, análises

e os datos masivos dos que todo o mundo fala

who are studied. That's what's leading to the guesswork.

permitirannos facer modelos preditivos para cada un de nós

The technologies that are coming,

como pacientes individuais.

high-performance computing, analytics,

A maxia é poder experimentar no meu avatar

big data that everyone's talking about,

will allow us to build predictive models for each of us

no programa, non no meu corpo mentres sufro.

as individual patients.

And the magic here is, experiment on my avatar

Agora quero compartir convosco dous exemplos

desta atención personalizada no meu percorrido.

in software, not my body in suffering.

O primeiro é bastante sinxelo.

Hai uns anos, decateime de que

os meus equipos médicos optimizaban o meu tratamento para obter a lonxevidade.

Now, I've had two examples I want to quickly share with you

of this kind of care customization on my own journey.

É como un honor ver canto tempo conseguen manternos vivos.

The first was quite simple. I finally realized some years ago

Eu estaba optimizando a miña vida para ter unha calidade de vida

that all my medical teams were optimizing my treatment for longevity.

que para min significa pasar tempo na neve.

It's like a badge of honor to see how long they can get the patient to live.

No meu historial obrigueilles a pór “Obxectivo do paciente:

I was optimizing my life for quality of life,

dose baixa de fármacos durante períodos máis longos;

and quality of life for me means time in snow.

efectos secundarios: pasar tempo esquiando”.

So on my chart, I forced them to put, "Patient goal:

(Risas)

E creo que por iso conseguín a lonxevidade.

low doses of drugs over longer periods of time,

Creo que pasar tempo na neve foi tan importante

como os medicamentos que recibín.

side effects friendly to skiing."

Segundo exemplo de personalización. Por certo,

And I think that's why I achieved longevity.

personalízase a atención ao saber as metas

I think that time-in-snow therapy was as important

e a atención sanitaria non as coñecerá ata que as coñezas.

as the pharmaceuticals that I had.

O segundo exemplo é que resultei ser unha cobaia

Now the second example of customization -- and by the way,

you can't customize care if you don't know your own goals,

e tiven a sorte de que se secuenciara todo o meu xenoma.

so health care can't know those until you know your own health care goals.

Necesitáronse dúas semanas de procesamento nos servidores máis avanzados de Intel

But the second example I want to give you is,

I happened to be an early guinea pig,

and I got very lucky to have my whole genome sequenced.

e seis meses de traballo humano e informático

para dar sentido a eses datos.

Now it took about two weeks of processing

Ao final, dixeron: “Si,

on Intel's highest-end servers to make this happen,

and another six months of human and computing labor

os diagnósticos daquel desacordo de titáns médicos

to make sense of all of that data.

de todos eses anos estaban equivocados

e temos un enfoque mellor”.

And at the end of all of that, they said, "Yes,

O futuro no que Intel traballa é descubrir

those diagnoses of that clash of medical titans

como a informática para a medicina personalizada

all of those years ago were wrong,

pase de meses a semanas e incluso horas e facer que este útil estea dispoñible

and we have a better path forward."

The future that Intel's working on now is to figure out

non só nos ordenadores centrais de investigación hospitalaria do mundo,

how to make that computing for personalized medicine

go from months and weeks to even hours,

senón para a poboación, para os pacientes, en cada clínica

and make this kind of tool available,

con acceso á secuenciación completa do xenoma.

not just in the mainframes of tier-one research hospitals around the world,

Este tipo de personalización da atención, dende os obxectivos ata a xenética,

but in the mainstream -- every patient, every clinic

será a atención máis revolucionaria

with access to whole genome sequencing.

que presenciaremos na atención sanitaria durante a nosa vida.

And I tell you, this kind of care customization

Estes tres piares de saúde persoal,

for everything from your goals to your genetics

atención ubicua, en rede e a personalizada,

will be the most game-changing transformation

that we witness in health care during our lifetime.

ocorren agora por partes,

pero esta visión fracasará por completo se non damos un paso adiante

So these three pillars of personal health,

care anywhere, care networking, care customization,

como traballadores da saúde e pacientes para desempeñar novos papeis.

are happening in pieces now,

É o que dicía a miña amiga Verna:

but this vision will completely fail if we don't step up

“Esperta e toma o control da túa saúde”, porque, ao final, estas tecnoloxías

as caregivers and as patients to take on new roles.

son novas e incribles formas de coidar outras persoas

It's what my friend Verna said:

Wake up and take control of your health.

e a nós mesmos.

Because at the end of the day these technologies

Deste modo, quero presentarvos moi rápido unha última amiga.

are simply about people caring for other people

Tracey Gamley ofreceuse para darme o ril imposible

and ourselves in some powerful new ways.

And it's in that spirit that I want to introduce you

(Aplausos)

to one last friend, very quickly.

que supostamente nunca tería.

Tracey Gamley stepped up to give me the impossible kidney

(Aplausos)

that I was never supposed to have.

(Applause)

Tracey, cóntanos un pouco como foi a túa experiencia como doante.

Tracey Gamley: Para min foi moi doado; só pasei unha noite no hospital.

So Tracey, just tell us a little bit quickly about what the donor experience was like with you.

A operación fíxose por laparoscopia,

polo que só teño cinco cicatrices moi pequenas no abdome.

Tracey Gamley: For me, it was really easy.

Estiven catro semanas sen traballar

I only had one night in the hospital.

e volvín facer todo o que facía antes sen ningún cambio.

The surgery was done laparoscopically,

so I have just five very small scars on my abdomen,

ED: É probable que nunca teña a oportunidade de agradecercho

and I had four weeks away from work

ante un público tan numeroso.

and went back to doing everything I'd done before

“Grazas” paréceme unha palabra moi trivial,

without any changes.

ED: Well, I probably will never get a chance to say this to you

pero grazas de todo corazón por salvarme a vida.

(Aplausos)

in such a large audience ever again.

So "thank you" feel likes a really trite word,

but thank you from the bottom of my heart for saving my life.

Este e todos os escenarios de TED

(Applause)

adoitan celebrar a innovación e as novas tecnoloxías,

e iso é o que fixen aquí hoxe.

This TED stage and all of the TED stages

E vin cousas asombrosas dos oradores de TED,

are often about celebrating innovation

quero dicir, riles artificiais, incluso imprimibles que están aparecendo.

and celebrating new technologies,

and I've done that here today,

Pero ata que todas estas tecnoloxías incribles

and I've seen amazing things coming from TED speakers,

estean dispoñibles para todos, e incluso cando o estean,

I mean, my gosh, artificial kidneys, even printable kidneys, that are coming.

depende de nós coidarnos e salvarnos uns aos outros.

But until such time that these amazing technologies

Espero que fagades posible a saúde persoal

are available to all of us, and even when they are,

para vós e para todo o mundo. Moitas grazas.

it's up to us to care for, and even save, one another.

(Aplausos)

I hope you will go out and make personal health happen

for yourselves and for everyone. Thanks so much.

(Applause)