0:00:16.252,0:00:19.901
When was the last time[br]you had human contact?

0:00:19.901,0:00:23.171
And I'm not talking about sex necessarily.

0:00:23.171,0:00:26.180
I'm talking about human touch,

0:00:26.180,0:00:29.153
such as a hug from your grandparents,

0:00:29.153,0:00:33.831
or a smile from your neighbour,[br]or a kiss from your child.

0:00:34.443,0:00:38.975
Scientists claim that there[br]are three basic needs in order to survive.

0:00:38.975,0:00:42.306
We need oxygen, food, and water.

0:00:42.306,0:00:46.536
And I want to suggest[br]a fourth one, which is touch.

0:00:46.536,0:00:51.071
And I will tell you a personal story,[br]how touch became so important to me.

0:00:51.671,0:00:53.506
I have five children.

0:00:53.506,0:00:55.979
My first are twin boys.

0:00:55.979,0:00:59.249
During their delivery[br]there were certain complications,

0:00:59.249,0:01:04.309
and Rotev, who is my second one,[br]was born without a pulse.

0:01:04.628,0:01:06.617
He underwent resuscitation

0:01:06.617,0:01:10.065
and was immediately moved[br]to the neonatal intensive care unit.

0:01:10.065,0:01:11.618
It all happened very fast.

0:01:11.618,0:01:15.676
I didn't have time to see him,[br]not to mention hold him.

0:01:15.676,0:01:19.858
Only after 36 hours we finally met.

0:01:19.858,0:01:22.951
I vividly remember[br]entering the department,

0:01:22.951,0:01:24.827
approaching the incubator,

0:01:24.827,0:01:28.496
and there he was, so tiny and fragile.

0:01:28.496,0:01:31.196
I wanted so much to touch him.

0:01:31.196,0:01:35.345
So the nurse took him gently[br]and put him in my arms.

0:01:36.055,0:01:39.909
I remember looking at him[br]and he felt uncomfortable.

0:01:39.909,0:01:43.251
His eyes were full of fear,[br]his heart rate was fast,

0:01:43.251,0:01:46.722
his breathing was shallow,[br]and he looked restless.

0:01:47.102,0:01:51.642
And it took a few moments [br]until he started to relax.

0:01:51.642,0:01:55.631
His heart rate decreased,[br]and he felt much more calm.

0:01:56.381,0:02:00.975
And I was trying to think,[br]"What just happened in the last moments?"

0:02:00.975,0:02:05.114
And then it occurred to me[br]that the last 36 hours

0:02:05.114,0:02:09.771
he endured a battery of tests,[br]examination, pinprick needles.

0:02:09.771,0:02:11.443
He was handled,[br]

0:02:11.443,0:02:15.413
but not even one time[br]it had a loving touch.

0:02:16.134,0:02:19.298
I felt that it was not only my presence,

0:02:19.298,0:02:23.426
but also my touch that created the change.

0:02:23.426,0:02:27.957
And only 48 hours later[br]we got the permission to go home.

0:02:28.577,0:02:33.681
So I felt it then as a mom,[br]and I know it today as a physician,

0:02:33.681,0:02:35.756
touch can heal.

0:02:36.516,0:02:41.138
So I became a paediatrician[br]and my specialty is premature babies.

0:02:41.138,0:02:43.383
I am the director[br]of the Neonatal Department

0:02:43.383,0:02:45.886
in one of the leading hospitals[br]in our country,

0:02:45.886,0:02:47.966
and the biggest in the Middle East.

0:02:47.966,0:02:49.614
And it's a beautiful profession.

0:02:49.614,0:02:51.225
I mean, we create life.

0:02:51.225,0:02:56.075
We bring a one-pound baby[br]to grow into a 100-pound person.

0:02:56.075,0:02:57.719
It's really amazing.

0:02:58.129,0:03:02.872
Prematurity is a baby[br]that's born before 37 weeks,

0:03:02.872,0:03:05.248
or before the eighth month of pregnancy.

0:03:05.248,0:03:09.706
And we treat extremely small babies,[br]even less than one pound.

0:03:09.708,0:03:11.678
They are extremely vulnerable.

0:03:11.678,0:03:15.859
All their vital organs are not developed,[br]especially their lungs,

0:03:15.859,0:03:19.110
and we give oxygen through[br]mechanical ventilation.

0:03:19.110,0:03:22.126
We give food and water through IV lines.

0:03:22.896,0:03:26.566
And we succeeded to decrease mortality[br]in the last decade.

0:03:26.566,0:03:32.828
However, we still have many complications,[br]especially neurodevelopmental ones,

0:03:32.828,0:03:35.340
and we try to improve our outcome.

0:03:36.050,0:03:40.335
And I always say that when we try[br]to improve something in the future,

0:03:40.335,0:03:44.993
we have to go back to our past,[br]to go back to our basics.

0:03:44.993,0:03:47.275
And what are our basics?

0:03:47.275,0:03:50.564
Our basics is what I call the 3 C's:

0:03:50.564,0:03:55.294
It's contact, connection, and compassion,[br]and I will elaborate.

0:03:55.744,0:03:58.235
I remember one day,[br]walking in the department,

0:03:58.235,0:04:01.200
I saw a mom sitting near the incubator,

0:04:01.200,0:04:05.585
and she just had twin girls,[br]33 weeks, two pounds each,

0:04:05.585,0:04:09.237
and she was sitting very distant[br]from the incubator.

0:04:09.237,0:04:13.588
And I approached her and I asked her,[br]"Why aren't you touching your girls?

0:04:13.588,0:04:16.788
Why don't you have[br]skin-to-skin contact with them?"

0:04:17.458,0:04:20.036
And she said, "I don't know.[br]They are so small.

0:04:20.036,0:04:22.547
And all these pipes[br]and the tubes out of them,

0:04:22.547,0:04:27.347
and I'm afraid that if I touch them,[br]I'll get connected,

0:04:27.997,0:04:30.098
and they might not survive."

0:04:31.278,0:04:36.051
I told her, "Your touch[br]can help them survive."

0:04:36.841,0:04:40.473
Just recently there was a publication[br]from Harvard University,

0:04:40.473,0:04:44.402
claiming that the skin-to-skin care[br]for low birth weight

0:04:44.402,0:04:47.941
reduced mortality in 36 percent.

0:04:48.281,0:04:50.040
That's not a small number.

0:04:50.540,0:04:53.071
What happens medically when we touch?

0:04:53.741,0:04:57.911
When we are being touched,[br]there is a release of oxytocin.

0:04:57.911,0:05:01.297
It's a hormone.[br]We call it the 'bonding hormone'.

0:05:01.297,0:05:03.230
When oxytocin is released,

0:05:03.230,0:05:06.875
cortisol levels decrease,[br]heart rate decreases,

0:05:06.875,0:05:10.105
and we feel much more trust and secure.

0:05:10.105,0:05:14.565
When being touched,[br]we feel less pain and less stress.

0:05:14.565,0:05:19.403
For the mom, skin-to-skin care[br]enhances her breast milk production.

0:05:19.403,0:05:24.227
And when pre-terms are being touched,[br]it improves their weight gain.

0:05:24.227,0:05:28.540
And I think it's the only time in our life[br]we are very happy gaining weight.

0:05:30.334,0:05:34.766
So she listened carefully[br]and she started to touch her girls,

0:05:35.236,0:05:37.720
and to have skin-to-skin[br]contact with them.

0:05:38.089,0:05:42.078
And they are five years old now,[br]and beautiful girls.

0:05:43.319,0:05:46.109
(Applause)

0:05:48.810,0:05:51.869
But contact is not only physical.

0:05:51.869,0:05:53.956
We need to create connection.

0:05:53.956,0:05:55.996
We need our second C.

0:05:56.464,0:06:02.048
And there is a joke about our profession[br]that we are like veterinary medicine,

0:06:02.048,0:06:05.851
both of us do not really speak[br]with the patients.

0:06:05.851,0:06:06.889
And that's true,

0:06:06.889,0:06:09.979
we don't really communicate[br]with the babies and with the children,

0:06:09.979,0:06:12.518
but we do have our parents,

0:06:12.518,0:06:16.359
and the parents are our patients as well.

0:06:17.740,0:06:20.923
Parents are overwhelmed[br]with the situation they are in.

0:06:20.923,0:06:23.722
Suddenly they have a baby;[br]before time they didn't plan it.

0:06:23.722,0:06:26.154
They spend weeks and months[br]in our department.

0:06:26.154,0:06:29.154
And sometimes[br]in life-threatening situations,

0:06:29.154,0:06:32.527
and they are in[br]extreme anxiety and stress.

0:06:32.527,0:06:35.419
And we need to treat them[br]and to help them,

0:06:35.419,0:06:40.758
because lowering their anxiety[br]helps the outcome of their baby.

0:06:40.758,0:06:46.050
I remember talking to parents a few hours[br]after the delivery of their child,

0:06:46.050,0:06:49.000
and I explained to them[br]about health issues

0:06:49.000,0:06:52.292
and what to expect in the next few days.

0:06:52.292,0:06:55.962
And they listened quietly[br]and nodded with their head.

0:06:56.552,0:06:59.730
Two days later, during morning round,[br]I saw them again,

0:06:59.730,0:07:04.620
and I asked the mom if everything is okay,[br]"Do you have any questions?"

0:07:05.059,0:07:08.295
She looked at me and she says,

0:07:08.295,0:07:12.405
"I don't know; nobody explained[br]anything up till now."

0:07:12.405,0:07:13.746
And I was in shock.

0:07:13.746,0:07:16.746
I was thinking in my head,[br]what does she mean, nobody explained?

0:07:16.746,0:07:17.755
It was me!

0:07:17.755,0:07:20.105
I explained everything two days ago!

0:07:20.605,0:07:24.395
And then I realised that she was right.

0:07:24.395,0:07:27.363
I didn't explain it properly.

0:07:27.363,0:07:29.954
I didn't create the connection.

0:07:30.914,0:07:35.929
I'm sure each one of you was at least[br]one time in the physician's office.

0:07:35.929,0:07:37.120
And it's always the same.

0:07:37.120,0:07:39.840
We enter into the doctor's,[br]we explain about our symptoms,

0:07:39.840,0:07:42.373
explain about what kind[br]of medication we need to take,

0:07:42.373,0:07:43.747
in a perfect monologue.

0:07:43.747,0:07:46.651
And then when he asks[br]if we have any questions,

0:07:46.651,0:07:48.996
we get into this mental freeze.

0:07:48.996,0:07:51.864
We just nod with our head,[br]and we go out.

0:07:51.864,0:07:54.276
And five minutes after we go out[br]from the clinic,

0:07:54.276,0:07:57.890
we remember we forgot to ask[br]so many questions about side effects,

0:07:58.860,0:08:02.183
and actually 50 percent[br]of what he said, we forgot.

0:08:02.537,0:08:07.554
So we, as physicians,[br]need to explain things properly.

0:08:07.554,0:08:12.724
We need to create the connection[br]and to give our full attention.

0:08:13.664,0:08:16.294
So we decided to change things[br]in our department,

0:08:16.294,0:08:17.775
to have a new approach.

0:08:17.775,0:08:21.495
For example, we don't speak[br]with the parents near the incubator

0:08:21.495,0:08:23.645
or while handling the baby.

0:08:23.645,0:08:25.644
We take them to a quiet room.

0:08:25.994,0:08:27.864
We listen to their concerns.

0:08:27.864,0:08:30.377
We give them our full attention.

0:08:30.377,0:08:33.260
And at the end,[br]we added the question:

0:08:33.960,0:08:36.787
"What did you understand from all that?"

0:08:37.277,0:08:41.292
We also wanted to continue the contact[br]even when they're not in the department.

0:08:41.292,0:08:43.831
So we text them an SMS update.

0:08:43.831,0:08:48.102
Every morning at nine o'clock[br]they get an SMS regarding their child.

0:08:48.102,0:08:53.190
For example, "Your child is in room six.[br]His last weight is 1.7 pounds.

0:08:53.190,0:08:56.673
He finished all the bottles[br]and we need more breast milk."

0:08:57.843,0:09:00.776
And the results were amazing.

0:09:01.166,0:09:04.862
Parents felt much more reassured,

0:09:04.862,0:09:06.152
more confident.

0:09:06.152,0:09:08.383
They felt that we are available.

0:09:08.383,0:09:11.625
They had less anxiety and stress.

0:09:11.625,0:09:15.773
And actually, they felt that we care.

0:09:16.323,0:09:19.525
We created contact and connection,

0:09:19.525,0:09:22.625
and they felt our compassion.

0:09:24.625,0:09:26.421
We have the Levine family.

0:09:26.421,0:09:31.490
They come every year to celebrate[br]Daniel's birthday with us.

0:09:31.490,0:09:34.650
Daniel was a 24-week preterm,[br]extremely small,

0:09:34.650,0:09:36.317
had many, many complications.

0:09:36.317,0:09:40.087
The parents spent a month[br]in our department.

0:09:40.087,0:09:42.208
And every year, they come.

0:09:42.208,0:09:46.965
Mr Levine tells me,[br]"You know, Dr Strauss, I want to tell you

0:09:46.965,0:09:49.508
from the whole time we were here,

0:09:50.158,0:09:54.709
the main thing I remember[br]is the day Daniel was born.

0:09:54.709,0:09:58.090
I remember you and the team[br]rushing off to the delivery room.

0:09:58.090,0:09:59.492
Then he was in the incubator.

0:09:59.492,0:10:03.760
I joined you towards the department,[br]and suddenly you stopped,

0:10:03.760,0:10:08.817
you looked at me with a smile,[br]and you told me, 'Congratulations.'

0:10:09.416,0:10:14.067
And at that moment,[br]I understood that I am a father.

0:10:14.477,0:10:18.028
For better or worse, I am a father.

0:10:18.028,0:10:19.966
And it gave me hope."

0:10:20.616,0:10:23.938
So words created connection.

0:10:25.645,0:10:29.695
Unfortunately, not all[br]our preterms survive.

0:10:30.227,0:10:34.506
And sometimes during[br]the last day or moment,

0:10:34.506,0:10:36.687
parents have to disconnect.

0:10:37.427,0:10:42.662
We had one situation when a baby,[br]after an extremely difficult delivery,

0:10:42.662,0:10:46.469
did not survive and died after four days.

0:10:47.049,0:10:49.640
I remember the parents,[br]Sharon and her husband,

0:10:49.640,0:10:51.663
were not in the department[br]on the last day,

0:10:51.663,0:10:53.734
and I went outside to talk to them.

0:10:54.284,0:10:55.425
And I asked Sharon,

0:10:55.425,0:10:58.724
"Please, why don't you come[br]and say goodbye to your child?"

0:10:59.514,0:11:02.493
And she said,[br]"I cannot. It's too painful."

0:11:03.103,0:11:04.393
And I told her,

0:11:04.393,0:11:09.604
"I know it's the most difficult situation[br]I'm asking you to be in,

0:11:09.604,0:11:13.353
but it's extremely important[br]that you come and say goodbye to him."

0:11:14.173,0:11:16.021
And at the end she did.

0:11:16.531,0:11:19.570
And she came,[br]and we let her hold her baby,

0:11:19.570,0:11:24.210
and she sat there for a few moments,[br]saying goodbye to him.

0:11:26.519,0:11:30.589
Two years later, I got a call[br]from the maternity ward.

0:11:30.589,0:11:32.701
Someone wanted to see me.

0:11:33.411,0:11:36.938
So I came there,[br]and suddenly I saw Sharon.

0:11:37.478,0:11:39.572
And she just had a new baby.

0:11:40.652,0:11:43.019
And it was very emotional for both of us.

0:11:43.019,0:11:46.075
And she hugged me, and she said,

0:11:46.075,0:11:49.277
"I want to thank you all for insisting

0:11:49.277,0:11:52.761
that I will say goodbye[br]to my child two years ago,

0:11:52.761,0:11:56.568
because only like that[br]I could close that door

0:11:56.568,0:11:58.787
and continue on with my life.

0:11:58.787,0:12:02.136
And now I have a perfect, healthy child."

0:12:02.536,0:12:04.488
Touch can heal.

0:12:05.228,0:12:08.258
And we create contact.

0:12:08.258,0:12:10.696
And it's from a mother to her child,

0:12:10.696,0:12:13.357
from a physician to a patient,

0:12:13.357,0:12:15.798
from one person to another.

0:12:16.708,0:12:21.382
Our department is like[br]a microcosm of the universe.

0:12:21.382,0:12:25.724
When we encounter great joy[br]for bringing new life,

0:12:25.724,0:12:30.115
we encounter grief and sorrow[br]from occasional death,

0:12:30.115,0:12:33.924
we have sadness and happiness,

0:12:33.924,0:12:38.624
pain and joy, combined together,

0:12:38.624,0:12:43.724
and I know every day that I will[br]have to confront these mixed feelings,

0:12:43.724,0:12:48.463
and I cannot do that without compassion.

0:12:48.463,0:12:54.924
In our overwhelmed, hectic world,[br]where technology replaces everything,

0:12:55.674,0:13:01.348
it replaces even the essentials[br]such as oxygen, food, and water.

0:13:01.348,0:13:06.651
It cannot and will not replace compassion.

0:13:06.651,0:13:09.370
And we need compassion in this world.

0:13:10.009,0:13:12.468
Aren't they beautiful, these children?

0:13:12.468,0:13:14.484
We all feel compassion for babies.

0:13:14.484,0:13:16.702
We all want to hug and kiss them.

0:13:16.702,0:13:22.071
But somewhere, along our life course,[br]we forget this feeling.

0:13:22.545,0:13:26.086
And we need to go back to this feeling[br]of compassion for children.

0:13:26.086,0:13:28.326
We need to go back to our basics.

0:13:28.326,0:13:32.777
We need to go back to the contact,[br]connection, and compassion.

0:13:33.175,0:13:35.634
And we need to start with contact.

0:13:36.274,0:13:37.634
And don't misunderstand me,

0:13:37.634,0:13:41.724
I'm not saying you have to touch[br]every person that you see on the subway.

0:13:42.594,0:13:47.516
Contact means a tap[br]on the shoulder of a friend,

0:13:47.516,0:13:49.831
a high five to your colleague,

0:13:49.831,0:13:54.225
looking up from our computer,[br]and laptop, and cellphone,

0:13:54.225,0:13:56.723
and creating eye contact,

0:13:56.723,0:13:58.428
and smile.

0:13:58.958,0:14:02.055
So we create contact and connection,

0:14:02.055,0:14:05.815
inevitably we will have compassion.

0:14:07.205,0:14:09.402
So we can start today,

0:14:09.402,0:14:11.263
right here, right now.

0:14:11.263,0:14:14.251
Ask yourself every day:

0:14:14.251,0:14:17.451
Did I have any connection with others?

0:14:17.451,0:14:19.490
Was I present?

0:14:19.490,0:14:25.950
Did I give my full attention[br]to my mom, my friend, my child?

0:14:25.950,0:14:32.910
Because remember, your touch and smile[br]can create all the difference to them.

0:14:32.910,0:14:33.951
Thank you.

0:14:33.951,0:14:35.497
(Applause) (Cheers)