Fast Talk: Life Savers

One thing we can do is create a transparent environment for delivery of care. It is ridiculous that we can't have an environment where doctors and nurses, drug companies, and patients are encouraged to report misses, near misses, and accidents. And a serious commitment to transparency means tort reform of some kind. In Florida, the malpractice environment is so terrible that physicians are reluctant to write anything down when something goes wrong. Don't document. Don't pass it off. How completely backward.

I am positive that there are hundreds of hospitals around the nation making the same mistakes every day. They don't know they're all making the same mistakes, and they're not learning from one another. Internally, when there's a mistake, I can raise a fuss and do something about it. But outside of the Mayo Clinic, there isn't any mechanism for me to take action and prevent it from happening elsewhere. So basically, the business of saving lives isn't. The whole nonsystem system is killing people.

Artie Martin

Safety engineer, Vehicle Structure and Safety Integration Center
General Motors Corp.
Warren, Michigan

Seat belts, they say, save lives. And they do. It's still the single most critical message in vehicle safety. But we can save more lives if we can improve how people buckle up, and especially how kids are buckled in.

In the United States, four out of five child safety seats are used incorrectly. So one of the projects I've been working on is with an international consortium of car companies, government officials, and safety advocates on what's called LATCH (Lower Anchors and Tethers for Children). It's the new standardized child-restraint system in all new vehicles. Note the word standardized. The idea is, a harried parent can look for the same parts every time. Everything operates the same way. No more confusion.

Now did we agree on how to achieve that goal? Not on your life. Everybody had different concerns, and those concerns affected the design. In the United States, people aren't going to take an hour to put a child seat in the car if they can help it, so if it's easier to use, they're more likely to use it. In other countries, time isn't as much of an issue. Many Europeans, particularly the Germans, have laws that not only require passengers to wear seat belts but also kids to ride in the backseat until the age of 12. GM advocates that children sit in the rear seat, but in the United States, it doesn't always happen. Oftentimes, kids here ride in the front seat, so we had to take that into consideration. Meanwhile, some countries didn't even want to talk about kids who aren't properly restrained. In the end, we had two types of child seats, and we came up with a system that could work with both.

For 15 years, I've reviewed the performance of every GM vehicle sold in North America to ensure it meets crash-safety standards. That's a lot of cars. With the new child-restraint system, I'm helping to make all cars safer.

Eric Lander

Professor of biology, MIT
Founding director, The Broad Institute
Cambridge, Massachusetts

How do you save lives? You save lives through understanding. And you get understanding through the big picture. For the first time, it's becoming possible in the biological sciences to take the big picture--to see all of the components of the cell. Suddenly, biology and the business of saving lives are becoming computational.

In the 20th century, most work on disease required good luck. Today, we're making the fight against disease rational, giving medicine its periodic table of elements. If there are only 30,000 genes in the genome and something is wrong, then it has to be wrong with one of those 30,000 genes.

I don't like luck. I like a rational guarantee that if we work hard enough, we can find the cause of a disease. Now we're working on the systematic characterization of all the common variation in the human population. It turns out that there are only 10 million common genetic variants in the human population. Six years ago, we didn't know any of them. As of today, we know 5 million.

But this isn't just about the knowledge we produce. It's about the people we produce. Shaping the next generation of scientists is the greatest amplifier. David Altshuler came to MIT as a postdoc when the conventional wisdom was to focus on some gene--find one narrow problem and beat it to death. Instead, David focused on all genetic variation in the human genome. When I say we now have 5 million of the 10 million variants, it's largely due to projects that he launched. The notion that a postdoc could take on something like that is conceivable if you don't tell him it's not.

Believing in a mission is half of making it succeed. So it's the leader's obligation to believe in the mission, and to help everyone else overcome all doubts. I might say, "That's so unrealistic." But no progress is made without being unrealistic.