Vince Clark's journey to speak at last weekend's TEDxABQ in Albuquerque started several years ago.
It started with a father's love for his son, and his concern that his son wasn't receiving proper medical care, despite access he had to modern medicine and advance medical techniques.
"My son got very sick when he was nine. He developed a pain syndrome that developed into a motor illness," Clark said.
Clark's son Ryan was suffering with constant, near crippling pain and had developed Tourette's Syndrome-like tics, motor problems affecting his posture, muscle spasms and tremors.
Clark pulled Ryan out of school and the child was homeschooled for a year while Clark and his family spent time seeking out medical experts across seven states and six countries to figure out what was wrong with Ryan. Clark, an associate professor of Psychology and director of the department's new Clinical Neuroscience Center, drew upon his years of neuroscience expertise and consulted with more than 50 doctors during that year before figuring out what was wrong with Ryan, and more importantly, how to treat him so he could resume a normal childhood.
"The Mayo clinic said they couldn't help him," Clark said. "I took my first sabbatical after 14 years as a professor to spend more time taking care of him and looking for a solution."
Throughout that year, none of the doctors were able to give Clark or his family an adequate answer for his son's pain and suffering. Clark eventually was able to discover that a combination of medication and sloppy laboratory work misdiagnosed a rare secondary illness in his son. Once he was taken off of the medication and received the correct diagnosis, Ryan was properly treated and his pain and physical tics vanished.
Once Ryan recovered, Clark started investigating why it took so long for his son to be correctly diagnosed and treated. He wanted to know why so many doctors and scientists were wrong about the diagnosis.
"When the dust settled we started to look at the whole adventure and look at what went wrong and what it took to diagnose and cure him," Clark said.
His research led to an interesting conclusion.
As a society, Clark feels we have become used to the idea that "Big Medicine" - expensive medications costing billions of dollars to bring to market, complex surgery, electrodes implanted in patients - is seen as the silver bullet to better health care. It is the notion that more complex, complicated medical procedures are required to provide people with the best possible care.
"Both doctors and patients have made an assumption that this is the best solution and that there is no other solution available," Clark said.
What Clark feels is missing, and what he's addressing in his TED Talk, is the idea of "Small Medicine" - the less expensive, simpler and safer procedures are often as effective, if not more so, than the more expensive medical cures. Clark is presenting three lower cost medical modalities that he discovered as part of his research into the problems Ryan suffered.
"What I'm proposing is that first of all we all look at whether or not it's appropriate to look at ‘Big Medicine' as the only solution. And then to give ‘Small Medicine' a chance, or at least to take it seriously," Clark added.
The first is a simple way for people with neurological problems to reduce their neuromuscular tics using something as simple as an oral orthotic, much like a mouth guard, that helps reset the patient's jaw. When the patient bites down on the mouth guard, the pressure interacts with the nerves in the patient's jaw, which can reduce spasms in a matter of minutes for many patients.
Clark learned about this potential treatment from his colleague, Dr. Mark Cooper, a neuroscientist whose daughter suffered from symptoms similar to Ryan's. Cooper was examining ways to create cheaper versions of the mouth guard orthotic so future patients can try a variety of them, see which one works best for them and take it to a dentist to get a permanent version. Clark and Cooper have already published one academic paper on the potential of this treatment and are preparing for more studies before approaching the National Institute of Health to fund a larger study.
A patient who benefited from the trial study orthotic donated his own money to Clark and Cooper's team to study the effect this simple treatment has on the brain activity of those using this treatment.
"He paid his own money because he knows it works. He's frustrated that he doesn't see the medical community taking interest in this when it saved his life and allowed him to go back to work after being home, unable to work, for years," Clark said.
Another simple device Clark will talk about this weekend came from his previous research on brain stimulation. Several years ago Clark was working on a Department of Defense study examining the impact that a small electrical current running through someone's scalp into their brain would have on the ability to learn new tasks.
This research bore some interesting results. The electrical current doubled people's learning rate.
And how much electricity is needed for such an impressive increase? The answer's simplicity was surprising to Clark. A nine-volt battery could supply many doses of stimulation, between 10 and 20.
"It creates a small electric field that reaches into your brain and changes how different brain circuits function," Clark said. "This small change produces amazingly large results in the brain."
This stimulation, called transcranial direct current stimulation (tDCS), appears to produce localized changes in brain chemistry that promote creation of new memories. tDCS could help those with learning disabilities by altering the way people pay attention and perceive information in ways that can improve learning ability.
"It's possible that we might be able to increase attention in people with ADD," Clark said. "There is already a publication out there saying they have helped people with Alzheimer's."
Clark is already using tDCS to help treat drug addicts and reduce symptoms in people with Parkinson's disease. As a part of this research, Clark is examining the ability to use tDCS to treat chronic pain, which he learned about while trying to find ways to reduce the amount of pain Ryan suffered. He's been collaborating with other research groups that are having success using this procedure to reduce pain.
"It might be the first time that someone has come up with a way to treat pain consistently, but without using a drug," he added.
The third medical treatment that Clark is discussing at TEDxABQ comes from Clark's collaboration with a group headed by Dr. Michelle Espy at Los Alamos National Lab that has a major impact on the future of MRI scanning technology, making it less invasive and more available to those in poorer countries.
A problem Ryan had during was an inability to undergo MRI scans to examine what could be causing the pain because the vibration of the scan itself would cause too much pain. But the LANL group has been developing an "ultra low magnetic field" MRI.
This different type of MRI operates in a magnetic field much closer to that of the Earth's magnetic field, thousands of times lower than a regular MRI scan. A side benefit of working in this magnetic field is for people with metal in their bodies, such as pacemakers, or even metal workers who have tiny pieces of metal in their eyes. They were unable to have a traditional MRI in the past because the metal would disrupt the magnetic field needed in the scan, but they can undergo an ultra low field MRI.
Working with a lower magnetic field closer has also reduced the costs of producing an MRI scan, which could have an impact on health around the world. Clark points out that sub-Saharan Africa is home to only three MRI machines. For the entire population. Millions are unable to benefit from a traditional MRI, but with an ultra low field MRI, those people can now get some medical benefits, and doctors can decide if they need further treatment or not.
"It won't work the best in all cases, but it can give you some information, and it can help you decide if you need a traditional MRI," Clark said.
But the LANL team has run into many of the same problems as other ‘small medicine' research projects. Funding.
"They have had trouble getting funding because everyone is focused on what's bigger and larger and more complex and expensive and they are overlooking what could be a better alternative in some cases," Clark said.
Clark isn't asking people to turn their back's on "Big Medicine" and the advances that medical science has pioneered throughout the years. But he does ask the medical community not to jump immediately into "bigger and more complex" when looking at patients' needs.
"What I'm proposing is that we consider ‘small medicine' at least on an equal basis with ‘big medicine.' In some cases, ‘big medicine,' with complex and expensive solutions will be the best decision for a patient. But in other cases, ‘small medicine' – much easier, cheaper and safer – would be the best choice," he said.
Clark randomly discovered information about these three medical treatments during his research. He wasn't looking specifically for these potentially simpler treatments for patients. But seeing how simpler treatments so dramatically helped other's like Ryan made his search personal, beyond a purely academic exercise. And he wonders, what would happen if researchers made it a point to look for simpler, less invasive treatments for similar medical problems.
"It could be a revolution in medical care, and all of the political problems that come from expensive medical care," Clark said. "We spend so much money on it, what about if we make an attempt to reduce the cost of medical care."
As for Ryan, he has made a strong recovery and has even returned to school, recently starting his first year at Albuquerque Academy.
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