Show Me the Data: Becoming an Expert on Yourself: Talithia Williams at TEDxClaremontColleges

Dr. Talithia Williams' talk explores how each of us can begin to collect data about ourselves that can provide insight into our personal health.

As a kid I always loved information

that I could get from data

and the stories that could be told
with numbers.

I remember, growing up,
I'd be frustrated

at how my own parents
would lie to me using numbers.

"Talithia, if I've told you once
I've told you a thousand times."

No dad, you've only told me 17 times

and twice it wasn't my fault.
(Laughter)

I think that is one of the reasons
I got a Ph.D. in statistics.

I always wanted to know,

what are people trying to hide
with numbers?

As a statistician,

I want people to show me the data

so I can decide for myself.

Donald and I were pregnant
with our third child

and we were at about 41 and a half weeks,

what some of you may refer to
as being overdue.

Statisticians, we call that

being within the 95 percent
confidence interval.

(Laughter)

And at this point in the process

we had to come in every couple of days

to do a stress test on the baby,

and this is just routine,

it tests whether or not the baby
is feeling any type of undue stress.

And you are rarely, if ever,
seen by your actual doctor,

just whoever happens to be
working at the hospital that day.

So we go in for a stress test
and after 20 minutes

the doctor comes out and he says,

"Your baby is under stress,
we need to induce you."

Now, as a statistician,
what's my response?

Show me the data!

So then he proceeds to tell us

the baby's heart rate trace
went from 18 minutes,

the baby's heart rate was
in the normal zone

and for two minutes
it was in what appeared to be

my heart rate zone and I said,

"Is it possible that maybe
this was my heart rate?

I was moving around a little bit,

it's hard to lay still on your back,

41 weeks pregnant for 20 minutes.

Maybe it was shifting around."

He said, "Well, we don't want
to take any chances."

I said okay.

I said, "What if I was at 36 weeks

with this same data?

Would your decision be to induce?"

"Well, no, I would wait
until you were at least

38 weeks, but you are almost 42,

there is no reason
to leave that baby inside,

let's get you a room."

I said,
"Well, why don't we just do it again?

We can collect more data.

I can try to be really still
for 20 minutes.

We can average the two and see

what that means.
(Laughter)

And he goes,

"Ma'am, I just don't want you
to have a miscarriage."

That makes three of us.

And then he says,

"Your chances of having
a miscarriage double

when you go past your due date.
Let's get you a room."

Wow. So now as a statistician,
what's my response?

Show me the data!

Dude, you're talking chances,

I do chances all day long,
tell me all about chances.

Let's talk chances.
(Laughter)

Let's talk chances.

So I say, "Okay, great.

Do I go from a 30-percent
chance to a 60-percent chance?

Where are we here
with this miscarriage thing?

And he goes, "Not quite, but it doubles,

and we really just want
what's best for the baby."

Undaunted, I try a different angle.

I said, "Okay, out of 1,000
full-term pregnant women,

how many of them are going to miscarry

just before their due date?

And then he looks at me
and looks at Donald,

and he goes, about one in 1,000.

I said, "Okay, so of those 1,000 women,

how many are going to miscarry
just after their due date?"

"About two."
(Laughter)

I said, "Okay, so you are telling me
that my chances

go from a 0.1-percent chance

to a 0.2-percent chance."

Okay, so at this point
the data is not convincing us

that we need to be induced,

and so then we proceed
to have a conversation

about how inductions lead to a higher rate

of Cesarean sections, and if at all
possible we'd like to avoid that.

And then I said,

"And I really don't think
my due date is accurate."

(Laughter)

And so this really stunned him

and he looked sort of puzzled

and I said, "You may not know this,

but pregnancy due dates are calculated

assuming that you have
a standard 28-day cycle,

and my cycle ranges —

sometimes it's 27,
sometimes it's up to 38 —

and I have been collecting
the data to prove it.

(Laughter)

And so we ended up leaving the hospital
that day without being induced.

We actually had to sign a waiver
to walk out of the hospital.

And I'm not advocating
that you not listen to your doctors,

because even with our first child,

we were induced at 38 weeks;
cervical fluid was low.

I'm not anti-medical intervention.

But why were confident to leave that day?

Well, we had data
that told a different story.

We had been collecting data for six years.

I had this temperature data,

and it told a different story.

In fact, we could probably pretty
accurately estimate conception.

Yeah, that's a story you want to tell

at your kid's wedding reception.
(Laughter)

I remember like it was yesterday.

My temperature was a sizzling 97.8 degrees

as I stared into your father's eyes.
(Laughter)

Oh, yeah. Twenty-two more years,
we're telling that story.

But we were confident to leave
because we had been collecting data.

Now, what does that data look like?

Here's a standard chart

of a woman's waking body temperature

during the course of a cycle.

So from the beginning
of the menstrual cycle

till the beginning of the next.

You'll see that the temperature
is not random.

Clearly there is a low pattern

at the beginning of her cycle

and then you see this jump
and then a higher set of temperatures

at the end of her cycle.

So what's happening here?

What is that data telling you?

Well, ladies,
at the beginning of our cycle,

the hormone estrogen
is dominant and that estrogen

causes a suppression
of your body temperature.

And at ovulation,
your body releases an egg

and progesterone takes over,
pro-gestation.

And so your body heats up in anticipation

of housing this new little fertilized egg.

So why this temperature jump?

Well, think about
when a bird sits on her eggs.

Why is she sitting on them?

She wants to keep them warm,

protect them and keep them warm.

Ladies, this is exactly
what our bodies do every month,

they heat up in anticipation

of keeping a new little life warm.

And if nothing happens,
if you are not pregnant,

then estrogen takes back over
and that cycle starts all over again.

But if you do get pregnant, sometimes you

actually see another shift
in your temperatures

and it stays elevated
for those whole nine months.

That's why you see those pregnant women
just sweating and hot,

because their temperatures are high.

Here's a chart that we had
about three or four years ago.

We were really very excited
about this chart.

You'll see the low temperature level

and then a shift and for about five days,

that's about the time
it takes for the egg to travel

down the fallopian tube and implant,

and then you see those temperatures
start to go up a little bit.

And in fact, we had
a second temperature shift,

confirmed with a pregnancy test
that were indeed pregnant

with our first child, very exciting.

Until a couple of days later

I saw some spotting
and then I noticed heavy blood flow,

and we had in fact
had an early stage miscarriage.

Had I not been taking my temperature

I really would have just thought
my period was late that month,

but we actually had data to show

that we had miscarried this baby,

and even though this data
revealed a really

unfortunate event in our lives,

it was information
that we could then take to our doctor.

So if there was a fertility issue
or some problem,

I had data to show:

Look, we got pregnant,
our temperature shifted,

we somehow lost this baby.

What is it that we can do
to help prevent this problem?

And it's not just about temperatures

and it's not just about fertility;

we can use data about our bodies
to tell us a lot of things.

For instance, did you know that taking
your temperature can tell you a lot

about the condition of your thyroid?

So, your thyroid works a lot like
the thermostat in your house.

There is an optimal temperature
that you want in your house;

you set your thermostat.

When it gets too cold in the house,
your thermostat kicks in

and says, "Hey, we need
to blow some heat around."

Or if it gets too hot,
your thermostat registers,

"Turn the A.C. on. Cool us off."

That's exactly how your thyroid works
in your body.

Your thyroid tries to keep
an optimal temperature

for your body.

If it gets too cold, your thyroid
says, "Hey, we need to heat up."

If it gets too hot,
your thyroid cools you down.

But what happens when your
thyroid is not functioning well?

When it doesn't function, then it shows up

in your body temperatures,

they tend to be lower than normal
or very erratic.

And so by collecting this data

you can find out information
about your thyroid.

Now, what is it, if you had a thyroid
problem and you went to the doctor,

your doctor would actually test

the amount of thyroid stimulating hormone
in your blood.

Fine. But the problem with that test is

it doesn't tell you how active
the hormone is in your body.

So you might have
a lot of hormone present,

but it might not be
actively working to regulate

your body temperature.

So just by collecting
your temperature every day,

you get information
about the condition of your thyroid.

So, what if you don't want to take
your temperature every day?

I advocate that you do,

but there are tons
of other things you could take.

You could take your blood pressure,
you could take your weight —

yeah, who's excited about

taking their weight every day?
(Laughter)

Early on in our marriage,
Donald had a stuffy nose

and he had been taking
a slew of medications

to try to relieve his stuffy nose,
to no avail.

And so, that night he comes
and he wakes me up and he says,

"Honey, I can't breath out of my nose."

And I roll over and I look, and I said,
"Well, can you breath out of your mouth?"

(Laughter)

And he goes,
"Yes, but I can't breath out of my nose!"

And so like any good wife, I rush him

to the emergency room

at 2 o'clock in the morning.

And the whole time
I'm driving and I'm thinking,

you can't die on me now.

We just got married,

people will think I killed you!
(Laughter)

And so, we get to the emergency room,
and the nurse sees us,

and he can't breath out of his nose,

and so she brings us to the back
and the doctor says,

"What seems to be the problem?"

and he goes,
"I can't breath out of my nose."

And he said,
"You can't breath out of your nose?

No, but he can breath
out of his mouth. (Laughter)

He takes a step back
and he looks at both of us

and he says,
"Sir, I think I know the problem.

You're having a heart attack.

I'm going to order an EKG and a CAT scan

for you immediately."

And we are thinking, no, no, no.
It's not a heart attack.

He can breathe, just out of his mouth.

No, no, no, no, no.

And so we go back and forth
with this doctor

because we think
this is the incorrect diagnosis,

and he's like, "No really, it'll be fine,
just calm down."

And I'm thinking, how do you calm down?

But I don't think
he's having a heart attack.

And so fortunately for us, this doctor
was at the end of the shift.

So this new doctor comes in,
he sees us clearly distraught,

with a husband who can't breath

out of his nose.
(Laughter)

And he starts asking us questions.

He says, "Well, do you two exercise?"

We ride our bikes,
we go to the gym occasionally.

(Laughter)

We move around.

And he says, "What were you doing
just before you came here?"

I'm thinking, I was sleeping, honestly.

But okay,
what was Donald doing just before?

So Donald goes into this slew
of medications he was taking.

He lists, "I took this decongestant
and then I took this nasal spray,"

and then all of a sudden
a lightbulb goes off and he says,

"Oh! You should never mix this
decongestant with this nasal spray.

Clogs you up every time.
Here, take this one instead."

He gives us a prescription.

We're looking at each other,
and I looked at the doctor,

and I said,
"Why is it that it seems like you

were able to accurately diagnose
his condition,

but this previous doctor wanted to order

an EKG and a CAT scan?"

And he looks at us and says,

"Well, when a 350-pound man walks in the
emergency room and says he can't breath,

you assume he's having a heart attack

and you ask questions later."

Now, emergency room doctors
are trained to make decisions quickly,

but not always accurately.

And so had we had some information

about our heart health to share with him,

maybe we would have gotten a better
diagnosis the first time.

I want you to consider
the following chart,

of systolic blood pressure measurements

from October 2010 to July 2012.

You'll see that these measurements start

in the prehypertension/hypertension zone,

but over about the course
of a year and a half

they move into the normal zone.

This is about the heart rate
of a healthy 16-year-old.

What story is this data telling you?

Obviously it's the data from someone

who's made a drastic transformation,

and fortunately for us,
that person happens to be here today.

So that 350-pound guy that walked
into the emergency room with me

is now an even sexier and healthier

225-pound guy,
and that's his blood pressure trace.

So over the course of that year and a half

Donald's eating changed

and our exercise regimen changed,

and his heart rate responded,

his blood pressure responded
to that change

that he made in his body.

So what's the take-home message

that I want you to leave with today?

By taking ownership of your data
just like we've done,

just by taking this daily measurements
about yourself,

you become the expert on your body.

You become the authority.

It's not hard to do.

You don't have to have
a Ph.D. in statistics

to be an expert in yourself.

You don't have to have a medical degree

to be your body's expert.

Medical doctors,
they're experts on the population,

but you are the expert on yourself.

And so when two of you come together,

when two experts come together,

the two of you are able
to make a better decision

than just your doctor alone.

Now that you understand
the power of information

that you can get through
personal data collection,

I'd like you all to stand
and raise your right hand.

(Laughter)

Yes, get it up.

I challenge you to take ownership
of your data.

And today, I hereby confer upon you

a TEDx associate's degree
in elementary statistics

with a concentration
in time-dependent data analysis

with all the rights and privileges
appertaining thereto.

And so the next time
you are in your doctor's office,

as newly inducted statisticians,

what should always be your response?

Audience: Show me the data!
Talithia Williams: I can't hear you!

Audience: Show me the data!

TW: One more time!

Audience: Show me the data!

TW: Show me the data.

Thank you.

(Applause)