Ultramodern Medicine

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The Joy of High Tech

Rodford Edmiston

This being a collection of random thoughts on bits and pieces of technical information which should interest the technically oriented reader.

Please note that while I am an engineer (BSCE) and do my research, I am not a professional in this field. Do not take anything here as gospel; check the facts I give. And if you find a mistake, please let me know about it.

There are two forces acting to produce major changes in the way medicine is viewed and applied in this country, and to an extent in the rest of the world. The first is, not surprisingly, technical. The second is sociological.

Over the past two centuries there has been a large gain in information about biology in general, and human biology in particular. We are now reaching the point where the database is beginning to interconnect rather thoroughly. That is, each new fact is associated with several other facts, instead of just standing alone or being applied to a narrow field. Facets of knowledge about how our bodies and minds operate are forming into an integrated whole, with unanticipated associations allowing medical researchers to see items in their area of specialty from a new perspective. For instance, there is now a definite chemical basis for the long-theorized mind-body interaction.

Part of this eruption of information is the result of new testing and examination techniques. In the past few years, medical language has been flooded with such terms as CAT, SQUID, NMR and so on. These technologies, and others, along with new methodologies of data analysis, have shown us the workings of biology in ways never before seen. Protein sequencers allow researchers to not only create to order segments of pseudo life-stuff for study, but to make tools for examining the real thing.

The potential for treatment is also enormous. Not only has diagnosis improved, giving the patient a better chance of having his problem correctly identified, but the same tools allow for new methods of treatment. Imagine, instead of flooding the whole body with radiation or chemotherapy, placing a capsule of anti-cancer drug or radioisotope can be maneuvered into place via catheter, using one of the new scanning devices to help put it where it should go. It is not even activated until it is exactly where it is needed. Imagine molecules turned out by a protein or enzyme sequencer, which specifically attack key linkages in the DNA of cholera bacteria. Imagine artificial antibodies which latch onto molecules of wood alcohol, or some other common toxin, rendering it chemically harmless and making it easily swept from the bloodstream by the kidneys.

Gene therapy currently focuses on adding correct copies of genes to cells where the needed genes are missing or defective. Even without nanotechnology, it should soon be possible to perform chemical surgery on these defective genes, actually correcting errors. We have a good idea of how cellular DNA correction mechanisms work. Not only can the defects thus be eliminated from the individual cell, but from the person and the gene pool. Also, in cases where the problem was created by bad instructions from a defective gene in the womb or during childhood, by causing the expression of the corrected gene in an adult, we could cure many congenital defects. The limits will be less determined by technology than by law, since many improvements and enhancements will doubtlessly be either prohibited outright or severely restricted.

Okay, we can see how advances in medical technology and knowledge can help, but how does this make a revolution? That is where the second factor comes in.

The second factor, the social, is long overdue. The interaction between patient and doctor was largely shaped in the late eighteenth and early nineteenth centuries, when the first exposure most people had to modern doctors was the result of military service. Because of this, the practice developed of the doctor giving orders and the patient following them without question. Doctors were seen as somehow superior to ordinary men, beyond reproach by mere mortals. Any attempt by the atypical curious patient to obtain information was met with a smug assertion that it was beyond their understanding, or by a barrage of medical terms, casually tossed about. Unfortunately, this lead to an insular and elitist medical profession.

In the late nineteenth century, medical journals refused to print articles urging physicians to wash their hands before examination or surgery. The editors knew that dirty hands didn't cause disease. Their tune didn't change until patients began abandoning the traditionalists and flocking to doctors who used sterile procedures. This finally drove home to the critics that the success rate of the heretics was an order of magnitude better than that of the conservatives. In other words, the traditionalists wouldn't change until they realized that they were losing money, and some of them not then. Even today, about ten times as many people in the United States die from doctor's mistakes as from being deliberately shot. Yet any call for oversight from outside the medical community is derided by nearly all doctors.

The change has already been occurring gradually, due largely to the greater spread of information in the electronic age. Also, groups of "health food fanatics" have long challenged several firmly held beliefs of the medical establishment. Some of their claims have been vindicated so thoroughly that even the FDA has reluctantly admitted they have some validity, although for many of the claims this has taken twenty years or more. Naturally, the doctors have taken the "new" findings as their own, ignoring the previous history. Now, independent medical researchers are using the new technologies mentioned above to perform tests the established organizations refuse to consider. To the surprise of no one but medical conservatives, they are making wonderful progress. They are also using the underground communications network formed over the past few decades by the heretics to spread information about their finds. Combine those doctors willing to accept and use the new data with the creation and rapid spread of the nurse practitioner and other non-physician medical care positions and you have a revolution in progress.

Some of this information and attitude have leaked over into popular literature. This spread of hard data, combined with repeated scandals on the pricing and marketing practices of the major drug companies and FDA compliance in the matter, has resulted in many ordinary people beginning to question what their physicians tell them, or to at least ask for additional information. Doctors who stick with the old ways find themselves - again - with dwindling practices.

The real revolution, though, will come when the lawmakers either accept that the changes are inevitable and help them along, or refuse to do so and are faced with a having major (and routinely voting) segment of the population very angry with them. Fortunately, lawmakers are very aware that one of the most vociferous and issue-voting groups is the post-middle-aged, who are - a bit ironically - at the forefront of this new medicine. The population of the US is aging, and Baby Boomers - along with many others - are tired of being told "You're just getting old." Given the potential the new medicine has for helping people live long, healthy lives that attitude is certainly understandable. Any politician who does not understand this will most likely soon be looking for a new career.