TEDxProvidence
Alyson McGregor: Why medicine often has dangerous side effects for women
Alyson McGregor: Por que a medicina ten con frecuencia efectos secundarios perigosos para as mulleres?
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Durante a maior parte do século pasado, os medicamentos autorizados e comercializados probáronse só en doentes masculinos, o que supuxo que as doses non foran apropiadas e provocaran efectos secundarios nas mulleres. As importantes diferenzas fisiolóxicas entre homes e mulleres só se tiveron en conta na investigación médica recentemente. A médica de urxencias Alyson McGregor estuda esas diferenzas, e nesta fascinante charla expón a historia de como o modelo masculino se converteu na referencia para a investigación médica, e como entender as diferenzas entre homes e mulleres pode xerar tratamentos máis efectivos para ambos os sexos.
Alyson McGregor - Women's health pioneer
Alyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men. Full bio
Alyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men. Full bio
Double-click the English transcript below to play the video.
00:12
We all go to doctors.
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Todos nós imos ao médico.
00:16
And we do so with trust and blind faith
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E imos con confianza e fe cega
00:21
that the test they are ordering
and the medications they're prescribing
and the medications they're prescribing
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en que as probas que nos fan
e as medicacións que nos receitan
e as medicacións que nos receitan
00:25
are based upon evidence --
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están baseadas nas probas
00:28
evidence that's designed to help us.
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--probas deseñadas para axudarnos.
00:32
However, the reality is that that hasn't
always been the case for everyone.
always been the case for everyone.
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Aínda que a realidade é, que non sempre
foi así para todo o mundo.
foi así para todo o mundo.
00:39
What if I told you
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Que pasaría se lles dixera
00:40
that the medical science discovered
over the past century
over the past century
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que os descubrimentos da ciencia médica
ao longo do século pasado
ao longo do século pasado
00:44
has been based on only
half the population?
half the population?
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estaban baseados só
na metade da poboación?
na metade da poboación?
00:48
I'm an emergency medicine doctor.
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Eu son médica de urxencias.
00:50
I was trained to be prepared
in a medical emergency.
in a medical emergency.
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Formeime para estar preparada
nunha emerxencia médica.
nunha emerxencia médica.
00:54
It's about saving lives. How cool is that?
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Trátase de salvar vidas. É xenial, non si?
01:00
OK, there's a lot of runny noses
and stubbed toes,
and stubbed toes,
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Vale, hai moito nariz con mocos
e dedas esmagadas,
e dedas esmagadas,
01:03
but no matter who walks
through the door to the ER,
through the door to the ER,
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pero non importa quen entre
pola porta de Urxencias,
pola porta de Urxencias,
01:07
we order the same tests,
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nós pedimos as mesmas probas,
01:09
we prescribe the same medication,
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receitamos a mesma medicación,
01:11
without ever thinking about the sex
or gender of our patients.
or gender of our patients.
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sen sequera pensar no sexo
ou no xénero dos nosos doentes.
ou no xénero dos nosos doentes.
01:17
Why would we?
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Por que?
01:19
We were never taught that there were
any differences between men and women.
any differences between men and women.
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Nunca nos ensinaron que
había diferenzas entre homes e mulleres.
había diferenzas entre homes e mulleres.
01:22
A recent Government Accountability study
revealed that 80 percent of the drugs
revealed that 80 percent of the drugs
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Un estudo recente do Consello de Contas
revelou que o 80% dos medicamentos
revelou que o 80% dos medicamentos
01:27
withdrawn from the market
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retiráronse do mercado
01:29
are due to side effects on women.
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debido aos efectos secundarios
sobre as mulleres.
sobre as mulleres.
01:33
So let's think about that for a minute.
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Así que pensemos niso un minuto.
01:35
Why are we discovering
side effects on women
side effects on women
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Por que descubrimos
os efectos secundarios sobre as mulleres
os efectos secundarios sobre as mulleres
01:39
only after a drug has been
released to the market?
released to the market?
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só despois de que un medicamento
se retire do mercado?
se retire do mercado?
01:43
Do you know that it takes years
for a drug to go from an idea
for a drug to go from an idea
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Saben que un fármaco tarda anos
en pasar de ser unha idea
en pasar de ser unha idea
01:49
to being tested on cells in a laboratory,
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a ser probado en células nun laboratorio,
01:52
to animal studies,
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a estudos en animais,
01:54
to then clinical trials on humans,
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despois a ensaios clínicos en humanos,
01:56
finally to go through
a regulatory approval process,
a regulatory approval process,
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e ao final pasar un procedemento
para a súa aprobación,
para a súa aprobación,
02:00
to be available for your doctor
to prescribe to you?
to prescribe to you?
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ata estar dispoñible para que
o seu médico llo receite?
o seu médico llo receite?
02:06
Not to mention the millions and billions
of dollars of funding
of dollars of funding
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Por non mencionar, os miles de millóns
de dólares de financiamento
de dólares de financiamento
02:09
it takes to go through that process.
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que supón todo ese proceso.
02:13
So why are we discovering
unacceptable side effects
unacceptable side effects
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Entón, por que descubrimos
efectos secundarios inaceptables
efectos secundarios inaceptables
02:16
on half the population
after that has gone through?
after that has gone through?
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na metade da poboación
despois de pasar por todo isto?
despois de pasar por todo isto?
02:23
What's happening?
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Que está pasando?
02:24
Well, it turns out that those cells
used in that laboratory,
used in that laboratory,
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Pois resulta que esas células
empregadas nese laboratorio,
empregadas nese laboratorio,
02:28
they're male cells,
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son células masculinas,
02:30
and the animals used
in the animal studies were male animals,
in the animal studies were male animals,
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e os animais empregados nos
estudos con animais eran machos,
estudos con animais eran machos,
02:34
and the clinical trials have been
performed almost exclusively on men.
performed almost exclusively on men.
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e os ensaios clínicos fixéronse
case exclusivamente en homes.
case exclusivamente en homes.
02:41
How is it that the male model became
our framework for medical research?
our framework for medical research?
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Como se converteu o modelo masculino
no referente na investigación médica?
no referente na investigación médica?
02:46
Let's look at an example that has been
popularized in the media,
popularized in the media,
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Vexamos un exemplo que se popularizou
nos medios de comunicación,
nos medios de comunicación,
02:50
and it has to do
with the sleep aid Ambien.
with the sleep aid Ambien.
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e ten que ver co somnífero Ambien.
02:53
Ambien was released on the market
over 20 years ago,
over 20 years ago,
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Ambien saíu ao mercado
hai vinte anos,
hai vinte anos,
02:58
and since then, hundreds of millions
of prescriptions have been written,
of prescriptions have been written,
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e dende entón, prescribíronse
centos de millóns de receitas,
centos de millóns de receitas,
03:03
primarily to women, because women
suffer more sleep disorders than men.
suffer more sleep disorders than men.
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sobre todo a mulleres, porque teñen
máis trastornos de sono que os homes.
máis trastornos de sono que os homes.
03:09
But just this past year,
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Pero só este último ano,
03:11
the Food and Drug Administration
recommended cutting the dose in half
recommended cutting the dose in half
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a Food and Drug Administration
recomendou reducir a dose á metade
recomendou reducir a dose á metade
03:14
for women only,
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só para as mulleres,
03:17
because they just realized
that women metabolize the drug
that women metabolize the drug
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porque se decataron de que a muller
metaboliza o medicamento
metaboliza o medicamento
03:20
at a slower rate than men,
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a un ritmo máis lento que o home,
03:23
causing them to wake up in the morning
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por isto espertan pola mañá
03:25
with more of the active drug
in their system.
in their system.
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cos efectos do medicamento
activos no seu organismo.
activos no seu organismo.
03:28
And then they're drowsy and they're
getting behind the wheel of the car,
getting behind the wheel of the car,
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E entón, están somnolentas
e collen o coche,
e collen o coche,
03:32
and they're at risk
for motor vehicle accidents.
for motor vehicle accidents.
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e corren o risco
de ter accidentes de tráfico.
de ter accidentes de tráfico.
03:36
And I can't help but think,
as an emergency physician,
as an emergency physician,
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E eu non podo axudar, pero penso
como médica de urxencias,
como médica de urxencias,
03:40
how many of my patients
that I've cared for over the years
that I've cared for over the years
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cantos dos doentes aos que
atendín ao longo dos anos
atendín ao longo dos anos
03:45
were involved in a motor vehicle accident
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tiveron un accidente de tráfico
03:48
that possibly could have been prevented
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que posiblemente se puido evitar
03:52
if this type of analysis was performed
and acted upon 20 years ago
and acted upon 20 years ago
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se se fixera esta análise, e se actuase
en consecuencia hai 20 anos
en consecuencia hai 20 anos
03:57
when this drug was first released.
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cando este medicamento se aprobou.
04:01
How many other things need
to be analyzed by gender?
to be analyzed by gender?
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Cantas outras cousas teñen que
ser analizadas por xénero?
ser analizadas por xénero?
04:05
What else are we missing?
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Que máis estamos perdendo?
04:09
World War II changed a lot of things,
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A II Guerra Mundial cambiou
un montón de cousas,
un montón de cousas,
04:13
and one of them was this need
to protect people
to protect people
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e unha delas foi esta necesidade
de protexer a xente
de protexer a xente
04:16
from becoming victims of medical research
without informed consent.
without informed consent.
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de ser vítimas da investigación médica
sen consentimento informado.
sen consentimento informado.
04:21
So some much-needed guidelines
or rules were set into place,
or rules were set into place,
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Así que se estableceron guías e regras,
que eran moi necesarias,
que eran moi necesarias,
04:25
and part of that was this desire
to protect women of childbearing age
to protect women of childbearing age
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en parte porque estaba este desexo
de protexer as mulleres en idade fértil
de protexer as mulleres en idade fértil
04:30
from entering into any
medical research studies.
medical research studies.
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de entrar en calquera estudo
de investigación médica.
de investigación médica.
04:34
There was fear: what if something
happened to the fetus during the study?
happened to the fetus during the study?
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Había medo: e se lle pasaba algo
ao feto durante o estudo?
ao feto durante o estudo?
04:39
Who would be responsible?
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Quen sería o responsable?
04:41
And so the scientists
at this time actually thought
at this time actually thought
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E por iso os científicos
ao mesmo tempo pensaron
ao mesmo tempo pensaron
04:44
this was a blessing in disguise,
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que fora unha bendición disfrazada,
04:47
because let's face it -- men's bodies
are pretty homogeneous.
are pretty homogeneous.
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porque --sexamos realistas-- os corpos
dos homes son bastante homoxéneos.
dos homes son bastante homoxéneos.
04:52
They don't have the constantly
fluctuating levels of hormones
fluctuating levels of hormones
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Non sofren o cambio constante
nos niveis de hormonas
nos niveis de hormonas
04:56
that could disrupt clean data
they could get if they had only men.
they could get if they had only men.
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que podería alterar a precisión dos datos
que se recollerían só en homes.
que se recollerían só en homes.
05:01
It was easier. It was cheaper.
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Era máis doado. Era máis barato.
05:05
Not to mention, at this time,
there was a general assumption
there was a general assumption
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Sen mencionar, que daquela
había unha asunción xeral
había unha asunción xeral
05:08
that men and women
were alike in every way,
were alike in every way,
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de que homes e mulleres
eran parecidos en tódolos sentidos,
eran parecidos en tódolos sentidos,
05:12
apart from their reproductive organs
and sex hormones.
and sex hormones.
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á parte dos seus órganos reprodutivos
e as hormonas sexuais.
e as hormonas sexuais.
05:17
So it was decided:
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Así que estaba decidido:
05:21
medical research was performed on men,
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a investigación médica
realizábase en homes,
realizábase en homes,
05:24
and the results were later
applied to women.
applied to women.
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e os resultados aplicábanse
ás mulleres máis tarde.
ás mulleres máis tarde.
05:29
What did this do to the notion
of women's health?
of women's health?
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Que supuxo isto para a idea
de saúde das mulleres?
de saúde das mulleres?
05:32
Women's health became synonymous
with reproduction:
with reproduction:
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A saúde das mulleres converteuse
en sinónimo de reprodución:
en sinónimo de reprodución:
05:37
breasts, ovaries, uterus, pregnancy.
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peitos, ovarios, útero, embarazo.
05:42
It's this term we now refer
to as "bikini medicine."
to as "bikini medicine."
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É o que agora coñecemos
como “medicina bikini”.
como “medicina bikini”.
05:46
And this stayed this way
until about the 1980s,
until about the 1980s,
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E isto mantívose así ata
preto da década de 1980,
preto da década de 1980,
05:49
when this concept was challenged
by the medical community
by the medical community
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cando este concepto foi cuestionado
pola comunidade médica
pola comunidade médica
05:52
and by the public health policymakers
when they realized that
when they realized that
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e polos responsables das políticas
públicas de saúde, ao decatárense de que
públicas de saúde, ao decatárense de que
05:56
by excluding women
from all medical research studies
from all medical research studies
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excluíndo as mulleres de tódolos
estudos de investigación médica
estudos de investigación médica
06:01
we actually did them a disservice,
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en realidade fixémoslles un fraco favor,
06:04
in that apart from reproductive issues,
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xa que ademais dos temas reprodutivos,
06:06
virtually nothing was known
about the unique needs
about the unique needs
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case non se sabía nada
sobre as necesidades propias
sobre as necesidades propias
06:09
of the female patient.
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da doente muller.
06:12
Since that time, an overwhelming amount
of evidence has come to light
of evidence has come to light
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Dende aquela, unha chea de probas
saíron á luz
saíron á luz
06:18
that shows us just how different
men and women are in every way.
men and women are in every way.
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amosándonos como de diferentes son
homes e mulleres, en tódolos sentidos.
homes e mulleres, en tódolos sentidos.
06:29
You know, we have this saying in medicine:
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Sabedes que en medicina temos este dito:
06:32
children are not just little adults.
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Os menores non son coma adultos pequenos.
06:36
And we say that to remind ourselves
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E dicímolo para lembrarnos
06:38
that children actually have
a different physiology than normal adults.
a different physiology than normal adults.
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de que os menores teñen unha fisioloxía
distinta dos adultos normais.
distinta dos adultos normais.
06:44
And it's because of this that the medical
specialty of pediatrics came to light.
specialty of pediatrics came to light.
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E por iso xurdiu
a especialidade de pediatría.
a especialidade de pediatría.
06:49
And we now conduct research on children
in order to improve their lives.
in order to improve their lives.
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E agora facemos investigación en menores
para mellorar as súas vidas.
para mellorar as súas vidas.
06:57
And I know the same thing
can be said about women.
can be said about women.
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E eu sei que se pode dicir o mesmo
sobre as mulleres.
sobre as mulleres.
06:59
Women are not just men
with boobs and tubes.
with boobs and tubes.
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As mulleres non son homes
con peitos e trompas de Falopio.
con peitos e trompas de Falopio.
07:06
But they have their own
anatomy and physiology
anatomy and physiology
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Teñen a súa propia anatomía e fisioloxía
07:10
that deserves to be studied
with the same intensity.
with the same intensity.
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que merece ser estudada
coa mesma intensidade.
coa mesma intensidade.
07:15
Let's take the cardiovascular
system, for example.
system, for example.
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Collamos como exemplo
o sistema cardiovascular.
o sistema cardiovascular.
07:18
This area in medicine has done the most
to try to figure out
to try to figure out
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Esta área médica esforzouse en comprender
07:22
why it seems men and women have
completely different heart attacks.
completely different heart attacks.
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porque parece que homes e mulleres
teñen ataques cardíacos diferentes.
teñen ataques cardíacos diferentes.
07:27
Heart disease is the number one killer
for both men and women,
for both men and women,
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As cardiopatías son a primeira
causa de morte en homes e mulleres,
causa de morte en homes e mulleres,
07:33
but more women die within the first year
of having a heart attack than men.
of having a heart attack than men.
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pero morren máis mulleres ca homes
no primeiro ano de ter o ataque.
no primeiro ano de ter o ataque.
07:39
Men will complain
of crushing chest pain --
of crushing chest pain --
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Os homes vanse queixar
da esmagadora dor de peito--
da esmagadora dor de peito--
07:43
an elephant is sitting on their chest.
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teñen un elefante sentado no peito.
07:46
And we call this typical.
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E chamamos a isto, típico.
07:49
Women have chest pain, too.
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As mulleres tamén
teñen dor no peito.
teñen dor no peito.
07:52
But more women than men
will complain of "just not feeling right,"
will complain of "just not feeling right,"
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Pero máis mulleres que homes
vanse queixar só de "non sentirse ben".
vanse queixar só de "non sentirse ben".
08:00
"can't seem to get enough air in,"
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"parece como se me faltara vida",
08:03
"just so tired lately."
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"só un pouco de cansazo ultimamente".
08:07
And for some reason we call this atypical,
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E por algunha razón
chamámoslle a isto, atípico.
chamámoslle a isto, atípico.
08:09
even though, as I mentioned,
women do make up half the population.
women do make up half the population.
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aínda que como xa dixen,
as mulleres son a metade da poboación.
as mulleres son a metade da poboación.
08:15
And so what is some of the evidence
to help explain some of these differences?
to help explain some of these differences?
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Que probas temos
para axudar a explicar estas diferenzas?
para axudar a explicar estas diferenzas?
08:21
If we look at the anatomy,
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Se miramos a anatomía,
08:24
the blood vessels that surround the heart
are smaller in women compared to men,
are smaller in women compared to men,
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as arterias arredor do corazón
son máis pequenas en mulleres que en homes
son máis pequenas en mulleres que en homes
08:30
and the way that those blood vessels
develop disease is different
develop disease is different
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e o xeito en que esas arterias
desenvolven a enfermidade é diferente
desenvolven a enfermidade é diferente
08:35
in women compared to men.
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nelas ca neles.
08:37
And the test that we use to determine
if someone is at risk for a heart attack,
if someone is at risk for a heart attack,
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E as probas que usamos para determinar
se alguén poder ter un ataque ao corazón,
se alguén poder ter un ataque ao corazón,
08:43
well, they were initially designed
and tested and perfected in men,
and tested and perfected in men,
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ben, inicialmente foron deseñadas,
probadas e perfeccionadas en homes,
probadas e perfeccionadas en homes,
08:47
and so aren't as good
at determining that in women.
at determining that in women.
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e resulta que non son tan boas
para determinalo nas mulleres.
para determinalo nas mulleres.
Se pensamos nos medicamentos
08:52
And then if we think
about the medications --
about the medications --
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--medicamentos comúns que utilizamos,
como a aspirina.
como a aspirina.
08:55
common medications
that we use, like aspirin.
that we use, like aspirin.
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08:59
We give aspirin to healthy men to help
prevent them from having a heart attack,
prevent them from having a heart attack,
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Dámoslle aspirina aos homes sans
para axudalos a previr o infarto,
para axudalos a previr o infarto,
09:04
but do you know that if you
give aspirin to a healthy woman,
give aspirin to a healthy woman,
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pero sabedes que darlle
aspirina a unha muller sa
aspirina a unha muller sa
09:08
it's actually harmful?
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é en realidade prexudicial?
09:12
What this is doing is merely telling us
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Todo isto está a nos dicir
09:14
that we are scratching the surface.
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que estamos rabuñando a superficie.
09:19
Emergency medicine
is a fast-paced business.
is a fast-paced business.
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A medicina de emerxencias
avanza moi rápido.
avanza moi rápido.
09:23
In how many life-saving areas of medicine,
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En cantas áreas vitais
para a supervivencia,
para a supervivencia,
09:26
like cancer and stroke,
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coma o cancro e o ictus,
09:30
are there important differences between
men and women that we could be utilizing?
men and women that we could be utilizing?
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haberá diferenzas importantes entre
homes e mulleres que poderiamos utilizar?
homes e mulleres que poderiamos utilizar?
09:36
Or even, why is it that some people
get those runny noses
get those runny noses
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Ou incluso, por que hai xente
que ten máis mocos no nariz
que ten máis mocos no nariz
09:41
more than others,
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ca outra,
09:43
or why the pain medication that we give
to those stubbed toes
to those stubbed toes
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ou porque os medicamentos para
aliviar a dor das dedas esmagadas
aliviar a dor das dedas esmagadas
09:46
work in some and not in others?
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alivian a uns e a outros non?
09:53
The Institute of Medicine has said
every cell has a sex.
every cell has a sex.
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O Instituto de Medicina dixo que
cada célula ten un sexo.
cada célula ten un sexo.
09:59
What does this mean?
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E iso, que significa?
10:02
Sex is DNA.
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O sexo é o ADN.
10:04
Gender is how someone
presents themselves in society.
presents themselves in society.
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O xénero é como alguén
se presenta a si mesmo en sociedade.
se presenta a si mesmo en sociedade.
10:09
And these two may not always match up,
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E estes dous poden non sempre conxeniar,
10:12
as we can see with our
transgendered population.
transgendered population.
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como podemos comprobar
coa poboación transxénero.
coa poboación transxénero.
10:16
But it's important to realize
that from the moment of conception,
that from the moment of conception,
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Pero é importante decatarse disto
dende o momento da concepción,
dende o momento da concepción,
10:21
every cell in our bodies --
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cada célula nos nosos corpos
10:23
skin, hair, heart and lungs --
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--pel, pelo, corazón e pulmóns--
10:27
contains our own unique DNA,
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contén o noso propio e único ADN,
10:30
and that DNA contains
the chromosomes that determine
the chromosomes that determine
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e ese ADN contén
os cromosomas que determinan
os cromosomas que determinan
10:34
whether we become
male or female, man or woman.
male or female, man or woman.
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se seremos, feminino ou masculino,
home ou muller.
home ou muller.
10:40
It used to be thought
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Pensábase que
10:42
that those sex-determining
chromosomes pictured here --
chromosomes pictured here --
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eses cromosomas que determinan o sexo,
representados aquí
representados aquí
10:46
XY if you're male, XX if you're female --
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--XY se es home, XX se es muller--
10:49
merely determined whether you
would be born with ovaries or testes,
would be born with ovaries or testes,
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só determinaban se ti nacerías
con ovarios ou testículos,
con ovarios ou testículos,
10:54
and it was the sex hormones
that those organs produced
that those organs produced
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e eran as hormonas do sexo que
eses órganos producían
eses órganos producían
10:58
that were responsible for the differences
we see in the opposite sex.
we see in the opposite sex.
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as responsables das diferenzas
que vemos no sexo oposto.
que vemos no sexo oposto.
11:04
But we now know that
that theory was wrong --
that theory was wrong --
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Pero agora sabemos que
esa teoría estaba equivocada
esa teoría estaba equivocada
11:09
or it's at least a little incomplete.
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--ou polo menos, está un pouco incompleta.
11:12
And thankfully, scientists like Dr. Page
from the Whitehead Institute,
from the Whitehead Institute,
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Menos mal que científicos como o Dr. Page
do Whitehead Institute,
do Whitehead Institute,
11:16
who works on the Y chromosome,
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que traballa no cromosoma Y,
11:18
and Doctor Yang from UCLA,
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e o doutor Yang da UCLA,
11:21
they have found evidence that tells us
that those sex-determining chromosomes
that those sex-determining chromosomes
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atoparon evidencias de que
eses cromosomas determinantes do sexo
eses cromosomas determinantes do sexo
11:26
that are in every cell in our bodies
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presentes en cada célula do noso corpo
11:29
continue to remain active
for our entire lives
for our entire lives
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permanecen activos durante
toda a nosa vida
toda a nosa vida
11:36
and could be what's responsible
for the differences we see
for the differences we see
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e poderían ser os responsables
das diferenzas que vemos
das diferenzas que vemos
11:40
in the dosing of drugs,
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na dosificación dos medicamentos,
11:42
or why there are differences
between men and women
between men and women
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ou en por que hai diferenzas
entre homes e mulleres
entre homes e mulleres
11:45
in the susceptibility
and severity of diseases.
and severity of diseases.
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na susceptibilidade e
gravidade das enfermidades.
gravidade das enfermidades.
11:51
This new knowledge is the game-changer,
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Este novo coñecemento
é un punto de inflexión,
é un punto de inflexión,
11:57
and it's up to those scientists
that continue to find that evidence,
that continue to find that evidence,
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e depende dos científicos que
continúen ata atopar esa proba,
continúen ata atopar esa proba,
12:00
but it's up to the clinicians
to start translating this data
to start translating this data
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pero depende dos profesionais clínicos
empezar a aplicar esa información
empezar a aplicar esa información
12:05
at the bedside, today.
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na consulta, hoxe.
12:09
Right now.
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Dende agora mesmo.
12:13
And to help do this, I'm a co-founder
of a national organization
of a national organization
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E para axudar a conseguilo,
cofundei unha organización nacional
cofundei unha organización nacional
12:16
called Sex and Gender
Women's Health Collaborative,
Women's Health Collaborative,
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chamada Sexo e Xénero
Saúde Colaborativa de Mulleres,
Saúde Colaborativa de Mulleres,
12:19
and we collect all of this data
so that it's available for teaching
so that it's available for teaching
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e recollemos toda a información
dispoñible para o ensino
dispoñible para o ensino
12:24
and for patient care.
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e para a atención ao doente.
12:26
And we're working to bring together
the medical educators to the table.
the medical educators to the table.
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E estamos traballando para que tamén
se apunten os formadores médicos.
se apunten os formadores médicos.
12:31
That's a big job.
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O que é un gran reto.
12:34
It's changing the way medical training
has been done since its inception.
has been done since its inception.
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Isto cambia o xeito en que se veu facendo
a formación médica desde as orixes.
a formación médica desde as orixes.
12:41
But I believe in them.
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Pero, eu creo neles.
12:43
I know they're going to see the value
of incorporating the gender lens
of incorporating the gender lens
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Sei que van ver o valor
de incorporar as lentes de xénero
de incorporar as lentes de xénero
12:49
into the current curriculum.
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no actual plan de estudos.
12:52
It's about training the future
health care providers correctly.
health care providers correctly.
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Trátase de formar aos futuros profesionais
da asistencia médica de forma correcta.
da asistencia médica de forma correcta.
13:00
And regionally,
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E a nivel rexional,
13:01
I'm a co-creator of a division within
the Department of Emergency Medicine
the Department of Emergency Medicine
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compartín a creación dunha sección
no Departamento de Medicina de Urxencias
no Departamento de Medicina de Urxencias
13:05
here at Brown University,
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aquí na Universidade Brown.
13:07
called Sex and Gender
in Emergency Medicine,
in Emergency Medicine,
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chamada Sexo e Xénero
en Medicina de Urxencias,
en Medicina de Urxencias,
13:09
and we conduct the research to determine
the differences between men and women
the differences between men and women
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e investigamos para determinar
as diferenzas entre homes e mulleres
as diferenzas entre homes e mulleres
13:14
in emergent conditions,
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en situacións de emerxencia,
13:16
like heart disease and stroke
and sepsis and substance abuse,
and sepsis and substance abuse,
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como infarto e ictus
e septicemia e abuso de substancias,
e septicemia e abuso de substancias,
13:21
but we also believe
that education is paramount.
that education is paramount.
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pero cremos tamén
que a educación é primordial.
que a educación é primordial.
13:27
We've created a 360-degree
model of education.
model of education.
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Creamos un modelo de educación integral.
13:31
We have programs for the doctors,
for the nurses, for the students
for the nurses, for the students
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Temos programas para médicos/as,
para enfermeiras/os, para estudantes
para enfermeiras/os, para estudantes
13:37
and for the patients.
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e para os pacientes.
13:39
Because this cannot just be left up
to the health care leaders.
to the health care leaders.
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Xa que isto non se lle pode deixar
só aos responsables sanitarios.
só aos responsables sanitarios.
13:44
We all have a role in making a difference.
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Todos nós temos un papel
para cambiar a situación.
para cambiar a situación.
13:48
But I must warn you: this is not easy.
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Pero debo avisalos: isto non é doado.
13:53
In fact, it's hard.
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En realidade, é complicado.
13:57
It's essentially changing the way
we think about medicine
we think about medicine
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En esencia, está cambiando o xeito
no que pensamos a medicina
no que pensamos a medicina
14:01
and health and research.
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a saúde, e a investigación.
14:05
It's changing our relationship
to the health care system.
to the health care system.
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Está mudando a nosa relación
co sistema sanitario.
co sistema sanitario.
14:09
But there's no going back.
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Pero non hai volta atrás.
14:13
We now know just enough
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Agora coñecemos o suficiente
14:17
to know that we weren't doing it right.
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para saber que
non o estabamos facendo ben.
non o estabamos facendo ben.
14:21
Martin Luther King, Jr. has said,
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Martin Luther King Jr. dixo que
14:24
"Change does not roll in
on the wheels of inevitability,
on the wheels of inevitability,
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"O cambio non chega
sobre as rodas do inevitable,
sobre as rodas do inevitable,
14:28
but comes through continuous struggle."
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pero si vén a través da loita continua"
14:32
And the first step
towards change is awareness.
towards change is awareness.
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E o primeiro paso cara ao cambio
é a conciencia.
é a conciencia.
14:36
This is not just about improving
medical care for women.
medical care for women.
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Isto non trata só de mellorar
os coidados médicos das mulleres.
os coidados médicos das mulleres.
14:40
This is about personalized,
individualized health care for everyone.
individualized health care for everyone.
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Trátase de atención médica personalizada,
individualizada para todo o mundo.
individualizada para todo o mundo.
14:47
This awareness has the power to transform
medical care for men and women.
medical care for men and women.
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Esta conciencia ten o poder para cambiar
a atención médica de homes e mulleres.
a atención médica de homes e mulleres.
14:54
And from now on, I want you
to ask your doctors
to ask your doctors
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E dende agora en diante, eu quero
que lle pregunten aos seus médicos
que lle pregunten aos seus médicos
15:00
whether the treatments you are receiving
are specific to your sex and gender.
are specific to your sex and gender.
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se os tratamentos que lles dan
son indicados para o seu sexo e xénero.
son indicados para o seu sexo e xénero.
15:06
They may not know the answer --
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Pode que non saiban a resposta
15:08
yet.
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--aínda.
15:11
But the conversation has begun,
and together we can all learn.
and together we can all learn.
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Pero a conversa empezou,
e todos xuntos podemos aprender.
e todos xuntos podemos aprender.
15:15
Remember, for me
and my colleagues in this field,
and my colleagues in this field,
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Lembren, para min
e os meus colegas neste campo,
e os meus colegas neste campo,
15:20
your sex and gender matter.
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o seu sexo e xénero importan.
15:23
Thank you.
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Grazas
15:24
(Applause)
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(Aplausos)
ABOUT THE SPEAKER
Alyson McGregor - Women's health pioneerAlyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men.
Why you should listen
Alyson J. McGregor MD is co-founder and director for the Sex and Gender in Emergency Medicine (SGEM) Division (formerly Women’s Health in Emergency Care) within the Department of Emergency Medicine at Warren Alpert Medical School of Brown University.
Her group's aim is to establish research and educational endeavors that promote sex- and gender-specific medicine and women’s health as they relate to emergency care. Dr. McGregor received her medical degree at Boston University School of Medicine and residency training at Brown, where she continues to work as an attending physician at RI Hospital Emergency Department. Dr. McGregor is an Associate Professor of Emergency Medicine and also serves as co-director for the SGEM Fellowship and co-founder of the national organization Sex and Gender Women’s Health Collaborative.
Alyson McGregor | Speaker | TED.com