Could an apple a day keep the doctor away? The mad march of computerised medicine.
The computer is such a ‘bone of contention’. It never fails to cause arguments. When things go wrong, I go into catastrophe mode and fear I will lose everything. Joan is more computer literate but can only help if she takes over. That feels precarious. I have to understand what is happening. It’s an impasse. So when anxiety meets frustration and nothing gets resolved, sparks begin to fly.
My computer has become an essential part of me; an auxiliary memory that I totally depend on. If it fails, then I fail. I have kept a diary since 1988. Everything notable I do, read about or experience is thought about and transcribed; then some of the record is reworked and sent out into the world as blogposts or articles or even another book. So losing all my material feels like the death of me as an independent agent of expression.
‘Come on, get over yourself’, I hear you say. or ‘Get back into therapy: it’s only a technical problem.’
I need to stop ranting, engage brain and work it out. But the world has shifted. In the nineteen sixties, while still at school, I learnt how to strip down and rebuild the engine of a 3-ton truck. I even got a badge for it. A decade later when I owned a 1948 short-wheel-base Land Rover, I prided myself that I could fix anything that went wrong in the engine. Then the world became computerised and too complicated to fix. Of course, even now I could learn how a computer works, but time is getting shorter and I have to ration my cognitive brain and prioritise.
The problems started earlier this year when I changed from a PC to an ‘all singing, all dancing’ Macbook-Pro. I then decided to change my service provider and email address. Talk about hubris; how did I ever think I was going to manage a machine with sufficient computing power to put a man on the moon and then make it infinitely more difficult by changing course for Saturn immediately after ‘lift off’. The data on the iCloud, my ‘eye in the sky’, kept disappearing and every time I restarted, a pop-up notice appeared, informing me that my old email address could not connect to the cloud. Atmospheric interference, no doubt! Undaunted – for the moment, I followed instructions and inserted my password, which it promptly deemed ‘incompatible with life’. In desperation, I clicked sign out, but the ‘bastard machine’ then announced that if I did that again, it would take all of my data off the ‘cloud’. That’s when I called Joan, who insisted on taking over and then berated me for being difficult. Moi? Difficult? Surely not!
In desperation, Joan advised contacting the Apple help desk. I was reluctant, fearing that I would not be able to communicate what was wrong and would end up chatting about the weather in New Delhi. I needn’t have feared. I have always had a thing about the Irish accent and Daniela spoke in such an entrancing celtic brogue, I was immediately charmed. She asked ‘oh so gently’ if she could have remote access to my computer. By now, I was in love; how could I refuse her anything. Patiently, she pointed out all the moves with a cute little pink arrow that danced over my screen and within ten minutes, we had signed out, stored all the data, signed in with the new email address and loaded it all up again. Magic! Daniela had resolved six month’s frustration solved in minutes!
Later, I received an email from Apple asking me for feedback on their service. ‘It was brilliant’, I told them and added ‘I only wish the NHS was as good. Have Apple ever thought of going into Health care? And warming to my theme, I added ‘You know the saying, ‘An Apple a Day keeps the doctor away’! At least it would make Daniela smile.
Afterwards, I got to thinking ‘Could that be the future?’ With such enormous pressure on health care resources, I could see the NHS not only providing a website like NHS Choices, offering information and advice to frequently asked questions, it might also put you though to an adviser, like the hologram doctor in Star Trek, but with an engaging Irish accent. But could they go a stage further? Technology already exists to record physiological data such blood pressure and pulse rate, ECG, gut motility and the electrical activity of the brain with miniature sensors and put it all on line. The same thing with some biochemical measurements such as haemoglobin, blood glucose, plasma electrolytes. Within the next twenty years, we might all be equipped with microchips implanted in our bodies; health sensors, connected wirelessly to transponders in our smart phones, which would communicate with our personal database in health clouds, and be able to despatch medicines, arrange remote body imaging and coordinate treatment programmes. It would still be medicine, but not as we know it.
It has often been said that a computer could do the job of a doctor. After all, if medicine is an exercise in making a specific diagnosis and applying a definitive treatment – a pill for every ill, then a robot could be programmed to follow the necessary algorithms and guidelines, and select the appropriate management choices based on their patients’ data. It’s a horrible prospect, but if medicine continues along its current systematic trajectory, that apocalyptic view of the future of health care may well come to pass.
There are, however, signs of change. If we take IBS as an example, the illnesses that affect most people are not necessarily the stereotypical result of specific pathological processes, they would seem to be more the complex individual responses to life situations, relationships and life style. Under those conditions, virtual diagnosis and remote treatment based on outdated algorithms can only lead to confusion, unhappiness and more ill health. To use a climate change metaphor, health clouds can only create ill winds. Only the government programmers and their fat controllers benefit. It’s not a far cry from remote medicine to population control.
When I worked with The IBS Network, we envisaged a more personal and engaging model. It included our IBS Self Care Programme as an on-line information resource, a helpline staffed by trained IBS nurses and a network of self help groups, run by trained group leaders with personal experience of IBS. This vision of the future was not a distant, virtual visual health service but more proximate personal advice and support delivered at centres throughout the country by people who understood what it was like to have IBS. The self help groups would spawn many others, all coordinated by the charity, and each empowering patients to know how best to find the solutions that were right for them. It was a kind of Utopia, and it might even work given the right political climate.
Unfortunately health care services, like our much vaunted NHS, is still careering along it’s trajectory of more technology, more distance and more control. Within twenty years, perhaps even ageing will be seen as a disease and treated remotely. I would then be in my nineties.
Beam me up, Scotty!
The Sensitive Gut 