COMMENTARY

Google for CV Cure: Gates and Zuckerberg for Prevention?

Melissa Walton-Shirley, MD

Disclosures

January 15, 2016

Andy Conrad, Bill Gates, and Mark Zuckerberg share an ubertransformative commonality; a burning desire to turn the world upside down, shake it, and then send it spinning in the opposite direction. Zuckerberg reinvented the telephone, called it Facebook, clicked "send request" and the world accepted. Gates replaced paper and the encyclopedia with a computer exposing all of history and knowledge bare and ready for the taking. At the American Heart Association Scientific Sessions in November of 2015, Google Life Science CEO Andy Conrad announced funding for what is in essence an archaeological dig for the cure for coronary artery disease. With a magnanimous contribution of $25 million (matched by another $25M from the AHA), he will send researchers into the dark abyss to search for the secret to life without cardiovascular illness.[1] It will be an epic adventure. But what if the answer is actually at the mouth of the abyss, back where the journey started? We need transformative thinking there, too, so that we can change the axis of our world and push it into a new permanent tilt toward longevity. Let's go for broke. Let's prevent in most humans, cure more humans, and detect illness in nearly all before it's too late.

The difference, of course, between having a great idea and effecting change is in the implementation. If one can't coordinate the players, fund the machinery, and then disperse the information, at the end of the day (or lifetime), a great idea is just a great idea. That's where we are with primary prevention. We talk about it and hope for it. We think we are studying it, but what we have to do is teach it, engrain it, and reinforce it. I'm not advocating the pharmacological approach to illness. We've mastered that quite well in America. We are ever-ready with a prescription but devoid of a plan. I'm suggesting we seize our very best opportunity: in our local kindergartens, and elementary, middle, and secondary schools. That is where we do a great job teaching our ABCs, how to run computer programs, and social skills, but we continue to omit even the most basic information about how our blood vessels, hearts, and brains can sustain us or end our lives forever.

As I stood before a jolly gray-haired gentleman in my exam room today, for a few moments I imagined him as a first grader, seated in a wooden school desk with a metal bottom. Notebooks and paper are falling out around his feet as he fidgets while the teacher directs the classroom to recite the multiplication table once again. I see life in his cheeks, rosy lips, and a spark in his eye as he looks out the window daydreaming about how he will run and play at recess. I see what he has become this afternoon on my exam table, then I see what he could have been, and my heart breaks. His legs no longer carry him at the early age of 65, his vitality stolen by diabetes and neuropathy. His median sternotomy incision is his permanent receipt for the $150K price tag for one surgery alone and shouts volumes about his lack of exercise, poor nutrition, and 30 years of smoking. He has been told to eat properly, exercise as best he can, and of course take his medications regularly. He gets very little of the "how" to fight the diseases he has developed at every office visit, and even less time for the "why."

I spent 60 minutes reviewing my new patient's record, asking and answering questions and, yes, actually touching and examining him, but 60 minutes will never replace what should have happened during his 12 years in the American education system. We had 12 long years to spend an hour per day teaching him how to avoid this broken body struggling for quality of life as his quantity is running out. We had our chance. We blew it, his and ours.

That is where folks like Zuckerberg and Gates could make the difference. They could change the score on a test I administered a year ago from 42% literacy of basic health-preservation knowledge to something impactful. We need their bucks and their innovative know-how to get the attention of our educators. It's not a selfish request, because it would benefit everyone who sits in a classroom. They could transform our entire health curriculum for grades K through 12 to not only encompass cardiovascular literacy but also branch out into the basics of our most common maladies. Just think if we could affect that literacy on the same scale as social media and internet fact-finding capabilities.

I left Kentucky in October and my position as a member of the governing board of the state's ACC chapter; health literacy was my platform. After a morning meeting 18 months ago with some great minds in Kentucky education, my enthusiasm was bolstered. After numerous unanswered phone calls to our state's department of education, I began to realize that innovation alone isn't going to work. Properly implementing millions upon millions of dollars' worth of funding is our only hope. With great minds and huge portfolios of the likes of Zuckerberg, Gates, or any of their friends and acquaintances who would be willing to help, we could have the funds and the machinery to grind to a halt the perpetual-motion machine of medical ignorance and illness. In America, we are rich in technology, but we are in a medical information and self-preservation desert and it's costing money, lives, and quality of life.

As healthcare providers, legislators, educators, and transformers, it is possible with coordination, dedication, and funding to change the course and prevalence of illness. As rich as we are and as smart as we are, I will never understand why we haven't done it already.

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