An image from one of TRIPP's virtual reality experiences for mental wellness. Nanea Reeves is TRIPP's CEO.
The "Making Sense of Science" podcast features interviews with leading experts about health innovations and the ethical questions they raise. The podcast is hosted by Matt Fuchs, editor of Leaps.org, the award-winning science outlet.
My guest today is Nanea Reeves, the CEO of TRIPP, a wellness platform with some big differences from meditation apps you may have tried like Calm and Headspace. TRIPP's experiences happen in virtual reality, and its realms are designed based on scientific findings about states of mindfulness. Users report feelings of awe and wonder and even mystical experiences. Nanea brings over 15 years of leadership in digital distribution, apps and video game technologies. Before co-founding TRIPP, she had several other leadership roles in tech with successful companies like textPlus and Machinima. Read her full bio below in the links section.
Nanea Reeves, CEO of TRIPP.
TRIPP
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This conversation coincided with National Brain Awareness Week. The topic is a little different from the Making Sense of Science podcast’s usual focus on breakthroughs in treating and preventing disease, but there’s a big overlap when it comes to breakthroughs in optimal health. Nanea’s work is at the leading edge of health, technology and the science of wellness.
With TRIPP, you might find yourself deep underwater, looking up at the sunlight shimmering on the ocean surface, or in the cosmos staring down at a planet glowing with an arresting diversity of colors. Using TRIPP for the past six months has been a window for me into the future of science-informed wellness and an overall fascinating experience, as was my conversation with Nanea.
Show notes:
Nanea and I discuss her close family members' substance addictions and her own struggle with mental illness as a teen, which led to her first meditation experiences, and much more:
- The common perception that technology is an obstacle for mental well-being, a narrative that overlooks how tech can also increase wellness when it’s designed right.
- Emerging ways of measuring meditation experiences by recording brain waves - and the shortcomings of the ‘measured self’ movement.
- Why TRIPP’s users multiplied during the stress and anxiety of the pandemic, and how TRIPP can can be used to enhance emotional states.
- Ways in which TRIPP’s visuals and targeted sound frequencies have been informed by innovative research from psychologists like Johns Hopkins’ Matthew Johnson.
- Ways to design apps and other technologies to better fulfill the true purpose of mindfulness meditation. (Hint: not simply relaxation.)
- And of course, because the topic is mental wellness and tech, I had to get Nanea's thoughts on Elon Musk, Neuralink and brain machine interfaces.
Here are links for learning more about TRIPP:
- TRIPP website: https://www.tripp.com/about/
- Nanea Reeves bio: https://www.tripp.com/team/nanea-reeves/
- Study of data collected by UK's Office for National Statistics on behavior during the pandemic, which suggests that TRIPP enhanced users' psychological and emotional mindsets: https://link.springer.com/chapter/10.1007/978-3-03...
- Research that's informed TRIPP: https://www.tripp.com/research/
- Washington Post Top Pick at CES: https://www.washingtonpost.com/technology/2019/01/...
- TRIPP's new offering, PsyAssist, to provide support for ketamine-assisted therapy: https://www.mobihealthnews.com/news/tripp-acquires...
- Randomized pilot trial involving TRIPP: https://bmjopen.bmj.com/content/bmjopen/11/4/e0441...
In the U.S. and Europe, it is illegal to reuse pacemakers and other implants. Therefore, cardiologists export them to the global South where they save the lives of people of all ages.
Often he observed there were no doctors in the E.R.s, and hte nurses could render only basic first aid. “When somebody fell into a coma, they fell into a coma,“ Israel remembers. “There weren’t even any defibrillators to restart a patient’s heart,” while defibrillators are standard equipment in most clinics in the U.S. and Europe as lifesaving devices. When Israel finally visited the largest and most modern hospital in Nairobi, he found it better equipped but he learned that its services were only available to patients who could afford them. The cardiologist there had a drawer full of petitions from patients with heart ailments who couldn’t afford lifesaving surgery. Even two decades ago, a pacemaker cost $5,000 in Kenya, which made it unaffordable for most Kenyans who earn an average of $600 per month.
Since 2003, Israel and a team of two doctors and two nurses visit Kenya and Zambia once or twice a year to implant German pacemakers for free. Notably, the pacemakers and defibrillators Israel exports to Africa would end up in the landfill in Germany. Clinics have to pay for specialized services to dispose of this medical equipment. “In Germany, I could go to jail if I used a defibrillator that is one day past its expiration date,“ Israel says, “but in Kenya, people don’t have the money for the cheapest model. What nonsense to throw this precious medical equipment away while people in poorer countries die because they desperately need it.“
Israel works at the breakpoint between the laws in a wealthy country like Germany and the reality in the global South. The U.S. and most European countries have strict laws that ban the reuse of medical implants and enforce strict expiration dates for medical equipment. “But if a pacemaker is a few days past its expiration date, it still works perfectly fine,“ Israel says. “And it also happens that we implant a pacemaker and five months later it turns out that the patient needs a different kind. Then we replace it and we’d have to trash the first one in Germany, though it could easily run another 12 years.“
“If we get this right, we have lots of devices we can implant, hips and knees, etcetera. Where this will lead is limitless," says Eva Kline Rogers, the program coordinator for My Heart, Your Heart.
Israel has been collecting donations of pacemakers and defibrillators from manufacturers but also from other doctors and from funeral homes for his nonprofit Pacemakers for East Africa since 2003. Most funeral homes in the U.S. and Europe are legally obliged to remove pacemakers from the dead before cremation. “Most pacemakers survive their owners,“ says Israel. He sterilizes the pacemakers and finds them a new life in East Africa. Studies show that reused pacemakers carry no greater risk for the patients than new ones.
In the U.S., University of Michigan professor Thomas Crawford heads up a similar initiative, My Heart, Your Heart. “Each year 1 to 2 million individuals worldwide die due to a lack of access to pacemakers and defibrillators,” the organization notes on its website. The nonprofit was founded in 2009, but it took four years for the doctors to get permission from the FDA to export pacemakers. Since receiving permission, the organization has sent dozens of devices to the Philippines, Haiti, Venezuela, Kenya, Sierra Leone and Ukraine. “We were the first doctors ever to implant a pacemaker in Sierra Leone in 2018,” says Crawford, who has traveled extensively to most of the recipient countries.
Even individuals can donate their pacemakers; the organization offers a prepaid envelope. “My mother recently passed and she donated her device,” says Tina Alexandris-Souphis, one of the doctors at University of Michigan who collaborates on My Heart, Your Heart. The organization works with World Medical Relief and the U.K. based charity Pace4Life to maintain a registry of the most urgent patients and send devices to where they are needed the most.
My Heart, Your Heart is also conducting a randomized controlled trial to provide further evidence that reused pacemakers pose no additional risk. “Our vision is that we establish this is safe and create a blueprint for organizations around the world to safely reuse these devices instead of them being thrown in the trash,” says Eva Kline Rogers, the program’s coordinator. “If we get this right, we have lots of devices we can implant, hips and knees, etc. Where this will lead is limitless.” She points out that in addition to receiving the donated devices, the doctors in the global South also benefit from the expertise of renowned cardiologists, such as Crawford, who sometimes advise them in complex cases.
And Adrian Baranchuk, a Canadian doctor at the Kingston General Hospital at the Queen’s University, regularly travels through South America with his “cardiology van” to help villagers in remote areas with heart problems.
Israel says that he’s been accused of racism, in thinking that these pacemakers are suitable for those in the global South - many of whom are people of color - even though officials in wealthier countries consider them to be trash. The cardiologist counters such criticism with stories about desperate need of his patients. At his first medical visit to Nairobi that he organized with a local cardiologist, six patients were waiting for him. “In Germany, they would all be considered emergencies,” Israel says. One eighty-year old grandmother had a heartrate of 18. “I’ve never before seen anything like this,” Israel exclaims. “At first I thought I couldn’t find her pulse before I realized that her heart was only beating once every three seconds.” After the surgery, she got up, dressed herself and hurriedly packed her bag, explaining she had a ton of work to accomplish. Her family was in disbelief, Israel says. “They told me she had been bedridden for five years because as soon as she tried to get up she would faint.”
Israel has been accused of racism, in thinking that these pacemakers are suitable for those in the global South even though they're considered to be trash by officials in wealthier countries. The cardiologist counters such criticism with stories about desperate need of his patients.
Carsten Israel
The hospital in Nairobi where Israel conducts the surgeries, charges patients $200 for the use of its facilities. If patients can’t afford that sum, Israel will pay it from the funds of his nonprofit. For some people, $200 far exceeds their resources. Once, a family from the extremely poor Northern region of Kenya told him they couldn’t afford the $3 for the bus ride to Nairobi. Israel suspected this was a pretense because they were afraid of the surgery and agreed to reimburse the $3, “but when they came, they were wearing rags and were so rail-thin, I understood that they really needed every cent they had for food.”
Israel is a renowned cardiologists in Germany. And yet, he considers his work in East Africa to be particularly meaningful. “Generally, most patients in Germany will get the treatment they need,” he says, “and I never before experienced that people have an illness that is easily curable but simply won’t be treated.” He also feels a heavy responsibility. Many patients have his personal cell phone and call him when they have problems or good news about how they’re doing.
Some of those progress reports come much faster than in Israel’s home country. Before he implanted a pacemaker in a tall Massai in Kenya, the man had been picked on by his family because he wouldn’t help much with the hard work on the family peanut farm. “When I examined him, he had a pulse of 40,” Israel says. “It’s a miracle he was even standing upright, let alone hauling heavy bags.” After the surgery, Israel advised his patient to stay the night for observation, but the patient couldn’t wait to leave. Two hours later, he returned, covered in sweat. He’d been running sprints with his brothers to test the new device. Israel shakes his head. In Germany, it would be unthinkable for a patient to engage in athletics immediately after surgery. But the patient was exuberant: “I was the fastest!”
The success stories are notable partly because the challenges remain so steep. In Zambia, for instance, there is a single cardiologist; she determined to become one after losing her younger sister to an easily curable heart disease. Often, the hospitals not only lack pacemakers but also sterile surgery equipment, antibiotics and other essential material. Therefore, Israel and his team import everything they need for the surgeries, including medication. If necessary, they improvise. “I’ve done surgery with a desk lamp hanging from the ceiling by threads,” Israel says. He already knows that he will need to return to Kenya in six months to replace the pacemaker of one of his patients and replace the batteries in others. If he doesn’t travel, lives are at risk.