[Music]
good afternoon everybody
it’s a pleasure to be here thank you to
Ted and the phenomenal team they have
for inviting me before I bore you with
some science I have to tell you the
first moment since the theme of today is
moments how I got to be here at TEDx
Patras two weeks ago I was giving a
lecture at a scientific meeting in
Athens and I was walking back from the
meeting down Vasily Sofia’s Avenue and I
passed the car and there were two
gentlemen sitting one was sitting in the
seat of the car with the door open and
one was sitting outside and they had
tags like this but I didn’t read the
tags they looked at me I looked at them
they looked at me funny I looked at them
back funny and I started walking down
the street and being somebody who grew
up in New York City I’m always conscious
of who’s behind you so these two people
are following me so I keep looking back
now I’m starting to think I have a
backpack with a computer if I swing the
backpack I’m gonna hurt them this is
maybe I can fight them off it’s not
going to be so bad if I kick one then I
can punch the other one and so I stopped
at the light I stopped at the light and
they come up to me and say and Mister
Saudis and I said yes and they said we
know you we know you and I said okay I
don’t know you and they said we have
been sending emails and we want to
invite you to TEDx Patris because we’ve
seen your picture and you walk down the
street and we recognized you I said okay
and they said can we buy you a cup of
coffee and I said where and they said we
could go there down the street I said
okay we can go there that’s how I got
the TEDx Patras today that was my first
moment
so thank you to both of the gentlemen
who didn’t mug me and take my wallet and
take my money so I I feel a little
intimidated because we heard so many
great philosophers people talk about
life stories and I’m going to bring it
down to some more basic science today I
want to know what kills 3000 Greek
citizens a year infections acquired in
hospitals 3000 Greek citizens a year and
many many more worldwide but Greece has
specifically a pretty significant
problem with what we call hospital
acquired infections so you go into the
hospital like the dirty said and you
come out with either you don’t come out
or you come out with multiple problems
due to something you caught in the
hospital you go to the operating room
and you come up with a complication
related to the to your operation more
importantly the majority of these
infections and I’ll get back to telling
you a little bit more about those are
caused by antibiotic resistant bacteria
bacteria for which the currently the
antibiotics we currently have are no
longer effective we are about to enter
something called the post-antibiotic era
an era that will take us back to the
time before World War two before Fleming
develop penicillin we are running out of
antibiotics the World Health
Organization has listed antibiotic
resistance and antibiotic resistant
infections as three as number three in
the global threats to health to public
health so little biology we and I know
you’re sitting there I’m gonna scare you
a little bit we we humans are about 37
trillion cells I want you to feel a
little icky now there are about 39
trillion bacterial cells crawling on you
inside of you and and in all our
orifices we are more bacteria than we
are human cells
when you expose those bacteria to
antibiotics they are much smarter than
we are we’ve evolved over generations
and ages bacteria evolve over hours and
days so they evolved to become resistant
to antibiotics very very quickly they’re
much smarter than we are so the more we
use antibiotics and the more we use them
inappropriately because actually myself
included I’m a physician most doctors
about 50% of the antibiotics we
prescribe are inappropriate or
unnecessary so we’ve created this
problem now and Greece particularly has
a very big problem with this and many
other southern European countries I’m
looking at my Italian and French friends
there have this problem with abuse of
any accent the Greece has the highest
rate of antibiotic consumption in the
European Union and the highest rate of
antibiotic resistance in the European
Union and among many of the developed
countries so we have to think about how
we’re going to break this this
antibiotic habit I mentioned earlier I
started off talking about infections
that happen in the hospital I said most
of these are antibiotic resistant so
let’s take a step back I want to tell
you a little bit about these healthcare
acquired infections and why it’s so
important that we do something about
them so what are they what happens
literally what happens when you go in
the hospital you go in the hospital and
doctors and I think have some doctor
colleagues here place tubes in us or in
our relatives or our family members
tubes that are needed to deliver
medicines that could save our lives
tubes that help us breathe every time we
breach the natural barrier our skin and
put tubes in it in ourselves we expose
ourselves to the risk of getting an
infection our natural state is not to
have tubes in our bodies so the you
increase the risk and then if those
tubes are not handled properly and what
do I mean handle properly hands and
practices what are the practices around
the appropriate handling of those tubes
one guess
an infection especially when there are a
lot of germs hanging around which which
it happens in hospitals the other way
you get healthcare acquired infections
is by transmitting infections from one
person to the other you’re laying in the
hospital and the person next door has a
cold or has diarrhea the physician
doesn’t wash their hand or their nurse
doesn’t wash your hand and all of a
sudden you came in for your broken leg
and now you have diarrhea and pneumonia
so just transmission of germs amongst us
and then finally a surgical infection so
you go into the operating room if best
practices are not adhere to you come out
with an infection that complicates what
should have been a very simple surgery
which brings me to the next moments the
World Health Organization has put out
there are five moments of hand hygiene
there are literally five moments that’s
what the campaign is the five moments of
hand hygiene
how we should wash our hands
appropriately we as health care
professionals cannot seem to wash our
hands I don’t know what it is is it
because it’s so simple that we think
it’s ridiculous
but if you read the scientific
literature it is the most effective way
to prevent infections why should we
present prevent them beyond the 3,000
that’s like we needed another reason
beyond 3,000 dead people a year in this
country it costs the Greek healthcare
system 1.2 billion euro a year so I want
you to think about that for a minute a
country in the financial crisis that
Greece is in right now pays 1.2 billion
for to manage these healthcare acquired
infections many cynics will say that
this is part of doing business this is
what happens if you go to a hospital
this is what happens this is unavoidable
the most important thing to take away
from all this is that about 70 percent
of these infections are preventable so
this has happened across the world
preventable there are countries that
have gotten too
infections in their hospitals and I
start off by saying hand hygiene but
there are other very simple basic
practices that could be followed but we
Greeks don’t like to follow rules we
don’t like to follow guidelines we don’t
like to follow algorithms and hence
we’ve created this very large problem
that is preventable in terms of both
lives lost and money safe for a system
that could use that money for something
else
my personal moment and why I’m here
talking about this I was sitting in my
office at the University of Pennsylvania
had been just promoted to professor at a
reasonably young age and I was thinking
about what what do I want to do what do
I want to do with my life what’s next I
need I wanted something beyond writing
another research paper or presenting at
another scientific meeting and what I
tell people is that I’m bipolar I don’t
mean bipolar as in really mentally ill
although I may be but that I’m half
Greek half American and the the Greek
side of me started really pulling at me
and that it was at the time of the
financial crisis and I said what do I
know how to do I know how to do
infectious diseases this is what I’ve
been trained to do in the States this is
what I could do so how can I contribute
and try to help in this time of crisis
and at a time when the health care
system was really feeling the burden of
these hospital-acquired infections my
colleague Nico’s talked about nikos
kazantzakis who’s one of my favorite
authors as well and I thought about
report to Greco and I thought what do I
want a report to Greco when I get to
sort of the end of my career in my life
so I came to Greece and and I started a
non-governmental organization called
Clio which is dedicated to preventing
hospital-acquired infections reducing
antibiotic resistance and improving our
use of antibiotics and we got together a
bunch of young people like ourselves who
either didn’t have jobs or wanted
something more important to do
and we came together in as an NGO that’s
been funded with help of the Stavros
Niarchos foundation which has invested
in this what I think they perceive as
important work what do we do we do a lot
of really simple things and I love the
simplicity of what we’re doing right now
trying to first of all we try to measure
the problem one of the things that was
missing is how big is the problem how
big isn’t in that problem in hospital a
hospital B hospital C and actually just
measuring the problem sometimes helps
because people start comparing
themselves to each other and say why do
I have a bigger problem than you maybe I
should do something better maybe I
should try to improve myself and then
just like the Research Institute or the
Institute that’s working on car injury
we implement interventions very simple
interventions how do we educate people
on proper hand-washing how do we get and
motivate them to wash their hands more
frequently and most of the interventions
are I hate to say not they don’t require
a lot of technology the airline industry
is the safest industry in the world do
you know why they use checklists that
you safety checklist they don’t leave it
to the pilot to think about whether
before takeoff or before landing they’ve
created a safe environment for the plane
to take in medicine now we’ve begun to
use these checklists as well this is
what I have to do as a doctor and if I
check all the boxes chances are my
patient will do well we as physicians
and in general don’t like to be told
what to do we don’t like to think that
medicine is not magic and following a
guideline or a checklist is something
that we don’t like to do but we need to
do more of it if we want to create a
better environment in terms of patient
safety and quality specifically around
infections but I would say even more
broadly
that the the final moments and I don’t
want to talk about negative moments but
I think you’ve heard some of these
things and you’ve probably known what I
heard the moments that I kept hearing
things like the borromini tokonoma we
can’t do it we can’t do it here you
can’t do this in Greece after seeing
America yes they come from the United
States you can’t do that here this is
impossible the infections are part of
doing business and you know I that
hasn’t seemed to to stop this I think
we’re still fighting this battle and I
encourage you to learn more about this
problem because I think 3,000 dead
people a year is pretty important and if
you can prevent those I want what I
would ask you as young people in the
audience and others is just to raise
awareness read about this a little bit
more and also hold your physicians
accountable when you go to the doctor
and they’re going to give you an
antibiotic ask them do I really need
that antibiotic is it going to make me
better in Greece we have
over-the-counter antibiotics where you
can get it at the pharmacy which is not
the pattern in most other countries at
least more so most other developed
countries why what do we know we as the
lay public in terms of what antibiotic
we should get or whether we should get
an antibiotic and I also encourage you
if you’re in a hospital unfortunate
enough to be in a hospital whether it’s
you or your relatives or somebody else
hold your doctors accountable tell them
to wash their hands before they do
something to you tell them to wash their
hands before they touch your yaga your
Popple your children your mother your
father and ask them are they following
best practices what are the practices
that you’re following to keep me safe
and to keep me from being one of those
one in 10 one in 10 Greek Greek citizens
who enter a hospital get a
hospital-acquired infection
finally just on a personal note when
they asked me to give this talk they
told me that I have 18 minutes to give
this talk and it was a particularly
difficult problem for me
I am from Acharya how many of you’ve
intake area good what is the sense of
time in Acharya so when they told me 18
minutes I said so you mean 3540 not
Obama me out it’s uh there’s no clocks
in Greece so this is very disconcerting
upsetting to me to see a clock here
that’s ticking and saying that you need
to sit to move forward thank you very
much
[Applause]
[Music]
you
[Music]
good afternoon everybody
it’s a pleasure to be here thank you to
Ted and the phenomenal team they have
for inviting me before I bore you with
some science I have to tell you the
first moment since the theme of today is
moments how I got to be here at TEDx
Patras two weeks ago I was giving a
lecture at a scientific meeting in
Athens and I was walking back from the
meeting down Vasily Sofia’s Avenue and I
passed the car and there were two
gentlemen sitting one was sitting in the
seat of the car with the door open and
one was sitting outside and they had
tags like this but I didn’t read the
tags they looked at me I looked at them
they looked at me funny I looked at them
back funny and I started walking down
the street and being somebody who grew
up in New York City I’m always conscious
of who’s behind you so these two people
are following me so I keep looking back
now I’m starting to think I have a
backpack with a computer if I swing the
backpack I’m gonna hurt them this is
maybe I can fight them off it’s not
going to be so bad if I kick one then I
can punch the other one and so I stopped
at the light I stopped at the light and
they come up to me and say and Mister
Saudis and I said yes and they said we
know you we know you and I said okay I
don’t know you and they said we have
been sending emails and we want to
invite you to TEDx Patris because we’ve
seen your picture and you walk down the
street and we recognized you I said okay
and they said can we buy you a cup of
coffee and I said where and they said we
could go there down the street I said
okay we can go there that’s how I got
the TEDx Patras today that was my first
moment
so thank you to both of the gentlemen
who didn’t mug me and take my wallet and
take my money so I I feel a little
intimidated because we heard so many
great philosophers people talk about
life stories and I’m going to bring it
down to some more basic science today I
want to know what kills 3000 Greek
citizens a year infections acquired in
hospitals 3000 Greek citizens a year and
many many more worldwide but Greece has
specifically a pretty significant
problem with what we call hospital
acquired infections so you go into the
hospital like the dirty said and you
come out with either you don’t come out
or you come out with multiple problems
due to something you caught in the
hospital you go to the operating room
and you come up with a complication
related to the to your operation more
importantly the majority of these
infections and I’ll get back to telling
you a little bit more about those are
caused by antibiotic resistant bacteria
bacteria for which the currently the
antibiotics we currently have are no
longer effective we are about to enter
something called the post-antibiotic era
an era that will take us back to the
time before World War two before Fleming
develop penicillin we are running out of
antibiotics the World Health
Organization has listed antibiotic
resistance and antibiotic resistant
infections as three as number three in
the global threats to health to public
health so little biology we and I know
you’re sitting there I’m gonna scare you
a little bit we we humans are about 37
trillion cells I want you to feel a
little icky now there are about 39
trillion bacterial cells crawling on you
inside of you and and in all our
orifices we are more bacteria than we
are human cells
when you expose those bacteria to
antibiotics they are much smarter than
we are we’ve evolved over generations
and ages bacteria evolve over hours and
days so they evolved to become resistant
to antibiotics very very quickly they’re
much smarter than we are so the more we
use antibiotics and the more we use them
inappropriately because actually myself
included I’m a physician most doctors
about 50% of the antibiotics we
prescribe are inappropriate or
unnecessary so we’ve created this
problem now and Greece particularly has
a very big problem with this and many
other southern European countries I’m
looking at my Italian and French friends
there have this problem with abuse of
any accent the Greece has the highest
rate of antibiotic consumption in the
European Union and the highest rate of
antibiotic resistance in the European
Union and among many of the developed
countries so we have to think about how
we’re going to break this this
antibiotic habit I mentioned earlier I
started off talking about infections
that happen in the hospital I said most
of these are antibiotic resistant so
let’s take a step back I want to tell
you a little bit about these healthcare
acquired infections and why it’s so
important that we do something about
them so what are they what happens
literally what happens when you go in
the hospital you go in the hospital and
doctors and I think have some doctor
colleagues here place tubes in us or in
our relatives or our family members
tubes that are needed to deliver
medicines that could save our lives
tubes that help us breathe every time we
breach the natural barrier our skin and
put tubes in it in ourselves we expose
ourselves to the risk of getting an
infection our natural state is not to
have tubes in our bodies so the you
increase the risk and then if those
tubes are not handled properly and what
do I mean handle properly hands and
practices what are the practices around
the appropriate handling of those tubes
one guess
an infection especially when there are a
lot of germs hanging around which which
it happens in hospitals the other way
you get healthcare acquired infections
is by transmitting infections from one
person to the other you’re laying in the
hospital and the person next door has a
cold or has diarrhea the physician
doesn’t wash their hand or their nurse
doesn’t wash your hand and all of a
sudden you came in for your broken leg
and now you have diarrhea and pneumonia
so just transmission of germs amongst us
and then finally a surgical infection so
you go into the operating room if best
practices are not adhere to you come out
with an infection that complicates what
should have been a very simple surgery
which brings me to the next moments the
World Health Organization has put out
there are five moments of hand hygiene
there are literally five moments that’s
what the campaign is the five moments of
hand hygiene
how we should wash our hands
appropriately we as health care
professionals cannot seem to wash our
hands I don’t know what it is is it
because it’s so simple that we think
it’s ridiculous
but if you read the scientific
literature it is the most effective way
to prevent infections why should we
present prevent them beyond the 3,000
that’s like we needed another reason
beyond 3,000 dead people a year in this
country it costs the Greek healthcare
system 1.2 billion euro a year so I want
you to think about that for a minute a
country in the financial crisis that
Greece is in right now pays 1.2 billion
for to manage these healthcare acquired
infections many cynics will say that
this is part of doing business this is
what happens if you go to a hospital
this is what happens this is unavoidable
the most important thing to take away
from all this is that about 70 percent
of these infections are preventable so
this has happened across the world
preventable there are countries that
have gotten too
infections in their hospitals and I
start off by saying hand hygiene but
there are other very simple basic
practices that could be followed but we
Greeks don’t like to follow rules we
don’t like to follow guidelines we don’t
like to follow algorithms and hence
we’ve created this very large problem
that is preventable in terms of both
lives lost and money safe for a system
that could use that money for something
else
my personal moment and why I’m here
talking about this I was sitting in my
office at the University of Pennsylvania
had been just promoted to professor at a
reasonably young age and I was thinking
about what what do I want to do what do
I want to do with my life what’s next I
need I wanted something beyond writing
another research paper or presenting at
another scientific meeting and what I
tell people is that I’m bipolar I don’t
mean bipolar as in really mentally ill
although I may be but that I’m half
Greek half American and the the Greek
side of me started really pulling at me
and that it was at the time of the
financial crisis and I said what do I
know how to do I know how to do
infectious diseases this is what I’ve
been trained to do in the States this is
what I could do so how can I contribute
and try to help in this time of crisis
and at a time when the health care
system was really feeling the burden of
these hospital-acquired infections my
colleague Nico’s talked about nikos
kazantzakis who’s one of my favorite
authors as well and I thought about
report to Greco and I thought what do I
want a report to Greco when I get to
sort of the end of my career in my life
so I came to Greece and and I started a
non-governmental organization called
Clio which is dedicated to preventing
hospital-acquired infections reducing
antibiotic resistance and improving our
use of antibiotics and we got together a
bunch of young people like ourselves who
either didn’t have jobs or wanted
something more important to do
and we came together in as an NGO that’s
been funded with help of the Stavros
Niarchos foundation which has invested
in this what I think they perceive as
important work what do we do we do a lot
of really simple things and I love the
simplicity of what we’re doing right now
trying to first of all we try to measure
the problem one of the things that was
missing is how big is the problem how
big isn’t in that problem in hospital a
hospital B hospital C and actually just
measuring the problem sometimes helps
because people start comparing
themselves to each other and say why do
I have a bigger problem than you maybe I
should do something better maybe I
should try to improve myself and then
just like the Research Institute or the
Institute that’s working on car injury
we implement interventions very simple
interventions how do we educate people
on proper hand-washing how do we get and
motivate them to wash their hands more
frequently and most of the interventions
are I hate to say not they don’t require
a lot of technology the airline industry
is the safest industry in the world do
you know why they use checklists that
you safety checklist they don’t leave it
to the pilot to think about whether
before takeoff or before landing they’ve
created a safe environment for the plane
to take in medicine now we’ve begun to
use these checklists as well this is
what I have to do as a doctor and if I
check all the boxes chances are my
patient will do well we as physicians
and in general don’t like to be told
what to do we don’t like to think that
medicine is not magic and following a
guideline or a checklist is something
that we don’t like to do but we need to
do more of it if we want to create a
better environment in terms of patient
safety and quality specifically around
infections but I would say even more
broadly
that the the final moments and I don’t
want to talk about negative moments but
I think you’ve heard some of these
things and you’ve probably known what I
heard the moments that I kept hearing
things like the borromini tokonoma we
can’t do it we can’t do it here you
can’t do this in Greece after seeing
America yes they come from the United
States you can’t do that here this is
impossible the infections are part of
doing business and you know I that
hasn’t seemed to to stop this I think
we’re still fighting this battle and I
encourage you to learn more about this
problem because I think 3,000 dead
people a year is pretty important and if
you can prevent those I want what I
would ask you as young people in the
audience and others is just to raise
awareness read about this a little bit
more and also hold your physicians
accountable when you go to the doctor
and they’re going to give you an
antibiotic ask them do I really need
that antibiotic is it going to make me
better in Greece we have
over-the-counter antibiotics where you
can get it at the pharmacy which is not
the pattern in most other countries at
least more so most other developed
countries why what do we know we as the
lay public in terms of what antibiotic
we should get or whether we should get
an antibiotic and I also encourage you
if you’re in a hospital unfortunate
enough to be in a hospital whether it’s
you or your relatives or somebody else
hold your doctors accountable tell them
to wash their hands before they do
something to you tell them to wash their
hands before they touch your yaga your
Popple your children your mother your
father and ask them are they following
best practices what are the practices
that you’re following to keep me safe
and to keep me from being one of those
one in 10 one in 10 Greek Greek citizens
who enter a hospital get a
hospital-acquired infection
finally just on a personal note when
they asked me to give this talk they
told me that I have 18 minutes to give
this talk and it was a particularly
difficult problem for me
I am from Acharya how many of you’ve
intake area good what is the sense of
time in Acharya so when they told me 18
minutes I said so you mean 3540 not
Obama me out it’s uh there’s no clocks
in Greece so this is very disconcerting
upsetting to me to see a clock here
that’s ticking and saying that you need
to sit to move forward thank you very
much
[Applause]
[Music]
you
[Music]
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