Today’s Medical Care: Like Star Trek’s Sickbay
When I was a child, I thought Star Trek’s Sickbay was a wonderful imagination of what medical care might be like … some day. It was, however, clearly a very long ways off. (When I say Star Trek, I mean the original series — and when I watched Star Trek, it was on NBC in the mid-1960s, not reruns.)
It seems like that “some day” has already arrived. Do you remember how Nurse Chapel carried around an electronic tablet on which she recorded information about patients? When I go into my doctor’s office, he enters my vital signs on a PDA — and my prescription goes straight from his PDA to the pharmacist across the street.
Do you remember how vital signs appeared above the patient in the Star Trek Sickbay — with no wires or connections? We’re not quite there yet, but when my daughter was born in 1983, many of the vital signs for my wife, such as blood oxygen content, were obtained using non-intrusive devices.
How would you know, in 1966, if someone had colon cancer? Usually the first hint were ugly stool symptoms, but to find out for sure would involve exploratory surgery. But starting in 1969, the medical profession started to experiment with a new procedure, colonoscopy. It is now so common that everyone over age 50 is strongly encouraged to have it done to make sure that there aren’t precancerous polyps. If there are growths, the doctor snips them out for biopsy in order to prevent them from turning into something more serious.
It is extremely hard for most people under 30 to appreciate how much advance there has been in medical care just in my lifetime. I am just old enough to remember standing in lines that went on for blocks for polio vaccine. America made the decision to vaccinate the entire country in a matter of months against this horrifying destroyer of young people — and we did it. (Today, I’m sure, lawsuits would block such a “risky” procedure.) I’m old enough to remember when measles, chickenpox, and mumps were not the names of vaccines, but diseases that just about every child was expected to catch. For a few, these “childhood diseases” would be more than just two weeks of misery and discomfort. Many of you readers have no concept of what you have missed, and how glad you should be to have missed it.
I guess what caused me to start thinking about this was a recent experience of a co-worker. In the course of an eye exam, the ophthalmologist noticed a growth on the back of her eye. How it was treated is like something right out of a Star Trek episode. A specialist here in Boise looked at the growth and wasn’t quite sure what it was. So my friend flew to San Francisco to see what I guess would have to be called a hyperspecialist. Biopsy determined that it was melanoma, a type of cancer, on the back of her eye. It is apparently a rather rare occurrence to have a melanoma there, but how the specialists treated it is what makes me feel like I’ve been jerked into a Star Trek-like future.
There was a time that melanoma in the eye would have meant loss of the eye before the cancer spread. At one time, doctors would have had no choice but to surgically remove the eye to get that cancer. More recently, they might have used gamma rays to destroy the melanoma. This process would have usually destroyed the rest of the eye. My co-worker benefited from a procedure in which the doctors used a focused proton beam to destroy the melanoma. Yes, you read that correctly. The surgeons put a small metal ring behind her eye and, relying on the fact that protons are electrically charged, focused the beam to destroy the melanoma without surgery — and without damaging the rest of her eye.
Medical care is hideously expensive in America, but that’s because medical care is spectacularly capable in America. Those of you under 30 may not appreciate how dramatically capable it is. Expensive? Yes, and worth every penny.
Clayton: Great article. We really have a lot to be thankful for these days. Now, if we could just get by the stupid referrals that are required even though the insurance does not require them. More articles like tlhis please. With love, Mom
DR McCoy
“He’s dead Jim….”
Expect to hear that a lot under Obamaism
Mr Cramer: Outstanding article. You and I are of the same era, and everything in this article is spot on. How can we get this wider distribution??
Phil
As a 63 year old curmudgeon who revels in his memories of Star Trek (not re-runs as Mr. Cramer notes) I too remember the Enterprise’s Sick Bay. 40 years later, I was diagnosed with lung cancer and am alive today because of breakthrough’s in surgery and chemo-therapy. I’ve been counting the weeks till the “magic” 5th year (February 6, 2011 if you want to know) when we say that the cancer is “cured.”
Should the cancer return, a slim, but possible eventuality, I have to wonder if the “powers that be” will decide that a younger person should get the life saving treatment instead of me. I have already beat the odds so far, but that would really tick me off.
It’s not just what takes place in doctor’s offices. My younger son, now aged 19, has cystic fibrosis, a genetic disease. When I was a boy, CF had barely been recognized and children suffering from it died at 18-24 months. My son is a college freshman and an athlete. Average age at death for CFers is 39 — and creeping up. My wife and I can harbor at least a hope that our son will live a normal lifespan. His therapies and medicines are expensive — but how much money would we swap for our son’s life?
@Dman: Also, “Damnit, I’m a bureaucrat, not a physician”.
Have you seen the recent commercial of the european and chinese parents asking the local doctor to check out the pain in thier sons stomach. Of course the doctor lifts the shirt and just sees the abdomen. The end of the commercial shows a modern parents asking a modern doctor the same question. The amazing sci fi thing is, the doctor pulls out a hand held ultra sound device. It has a wand(?) that is connected to a PDA like device and the amazing thing is it is real. The death of the American health care system means the end to miracle medicine. The Party of Death, the democrats, see letting the old and sick die as more efficient than trying to fing cures. What a shame.
The party of death, the democrats, do not realize that fighting to save every life leads to absolute miracle technology. As you relate in your article, the democrat death party would come to the conclusion that losing an eye is the most cost efficient way to treat the patient. Imagine the amount of money that went into finding the proton cure for the eye melanoma. The party of death, the democrats would see that as grossly cost prohibitive and pointless. We really need to stop the death of American healthcare. We need to save as many lives as we can.
The good news is that now that we have a new health care reform act for America, we should start having quality health care introduced for the first time. Though its mainly private orientated and not public, it will improve our current system. So star trek(ism) is now possible !
God Bless Our Great Health Care System !
@GM Roper How wonderful that you will be cancer free on 100th birthday of another curmudgeon. Ronald Reagan.
I’m old enough to have a small pox vaccine scar. Remember how they were scrambling for vaccine after 9-11 because the disease had been officially eradicated?
Health care expensive? Yes. I do not have insurance and have to pay for everything out of pocket. It’s worth every penny.
“Worth every penny.”
I’m sorry, but if you pay cash on the barrel for services you are going to be shocked if you have an accident. At the very least, talk to the conservatives around here and make sure you have some basic plan for catastrophic coverage.
I’m recovering from a broken leg (simple slip and fall on the icy sidewalk) and as I look through the bills, if I did not have health insurance I would have been billed close to $100,000. If you’ve got that kind of money lying around, then God bless, but the tender irony is that my insurance company has a negotiated rate of close to 50% off the rack price for healthcare.
Because as a cash paying customer, you get to subsidize everyone else who stiffs the hospital.
I would certainly discourage anyone with net assets of less than $5 million from having NO health insurance. The chances are low that you will ever get a horrendous medical bill–but if you do, it will take your breath away. And yes, cash (and insured) customers are subsidizing those who are not. All the more reason why a health care reform that decoupled health insurance from employment (such as with a refundable tax credit for health insurance costs) would have been a better approach than the Frankenstein that was just passed. But when Republicans were in control of both houses of Congress, the same special interest politics that passed this monster prevented anything reasonable from passing instead.
A few years ago, I spent a week in intensive care, and the bill was only $40,000.
What is astonishing is that during the entire march toward socialized medicine, we heard story after story of people who were without insurance, suffering, denied, sick, waaaaaaaaaaah. Yet so few stories (any, really?) of those of us who have been cured, healed, improved, rescued, brought-back-from-the-brink of death. No stories of how the system – under private means – has produced the best technology, pharmaceuticals, treatment centers and doctors and nurses on the planet.
“Beam me up, Scotty. There’s no intelligent life down here.” – Kirk, on a visit to Washington
The medical tri-corder is a portable MRI with a compendium of medical knowledge. The technician “reads” the diagnosis and suggest cure. Surgery is performed with a surgical transporter:no stitches. The transporter can also remove pathogens with the pattern buffer: refer original pattern to affected pattern and beam out the non-pattern. Quantum light optics replace x-rays and microscopes. Human genome patterning selects medications to the individual.
It is as likely that these will be invented by bureaucrats and politicians and ivory tower elites as it was for Thomas Edison to invent the light bulb or Effram Cochran to invent the warp drive:not! God bless free Enterprise and the creative mind!
It is always only a few people who see what is not there but can be. Medical progress has been slow in the last few decades but as reflected by the author has not come to a complete halt. Medicine all the way back in Greek and Roman Classical times has suffered from, in the words of the old joke it pays much better to treat the rich old lady than to cure her. The doctors in the joke were talking about scurvy but the advent of the FDA and public health has only made economic preference for treatment over cures many times worse.
If we want real Star Trek grade medicine like we have Star Trek grade Computers, (Quad core) Communicators(Cell phones and 4G) and View Screens(55″HD) We are going to have to provide economically certain ways for cure providers to overcome the FDA inflicted expenses. Maybe transferable tax credits that they could sell. Four times the average FDA expense provided in equal increments over ten years as long as the cure is on the market would be just about right.
It would defeat the businessman’s temptation to buy up a cure and keep it off the market. The only thing that I would add is that it would be wise to do this for the first three cures. Some people will be allergic and we want Business men racing with cures to the market. Maybe four times average FDA costs for the first place three times FDA and two times for third place.
That may be an old joke, but I’ve never met any doctors who practice medicine that way.
As to your claim that a businessman could buy up a cure, there is no real world incentive to do that.
Too bad the era of medical advancements has been brought to an end.
Great article, and it gets straight to the heart of the rise in medical costs. We’re not paying more money for the same cure, we’re paying more for a much better cure. I’d willingly shell out more money to keep my eye.
The problem with Obamacare is that it seeks simply to legislate the solution to a complex problem, rather than seeking out and addressing root causes. In essence, rather than treating the melanoma, it paints over it and declares it cured. Things may look fine for a while, but under the surface, the problems are only going to get worse.
Expensive? Yes. Here’s a way to cut down the health care costs. According to a Rand study of DEA data, the price of a gram of cocaine in 1981 was 600 dollars. In 2003 the same gram cost 100 dollars, in 2002 prices. The downward chart trend is amazing. So, make health care an illegal black market, and by introducing some of that old time crony capitalism where there is no recourse to dividing up market share through the courts by lawyers, and the price of drugs will come down, drastically. So we have a choice. Pay premium health care dollars to politicians and tort lawyers like Kerry and Edwards in Washington that exceed the inflation rate, or pay lower prices to Mexican drug cartels run out of Mexico City. Make your choice and pay your price. Of course, black markets tend to be violent, but that helps keep the population in check and demand for health care dollars stable while chasing a plentiful drug supply of increasing quality.
Proton beam therapy is indeed one of those high tech medical miracles. Much of the original investigation began in the early ’50s by Harvard and the Swedish center as they had the cyclotrons needed to produce the high energy proton beams.
Clinical use began in the late ’70s in Russia, and by far the largest number of patients treated is from Loma Linda Medical Center in California, a premier US institution subsidized by the Seventh Day Adventist church. Keep in mind that such treatments are seldom reimbursed in the intitial stages (which may take decades) by commercial insurance. All of these things are paid for and this is not capitalism until the technology is proven profitable.
According to the Particle Theory Co-operative group, an international ad-hoc coalition, 8 out of 34 currently operating centers are in the US. The rest are in Switzerland, Germany, France, Japan, Russia, S Korea, Sweden, UK, and Italy.
More info here: http://ptcog.web.psi.ch/ptcentres.html
Wonderful that US centers, especially those at Loma Linda and Harvard continue to be at the edge in this and have treated more than anyone else. It would be a terrible mistake to talk about that as some sort of proof of US vs. ‘socialized’ medicine. It is even a further leap of logic to talk about Obamacare in this context, a plan which does not address the issue of research at all.
Israel, for example, a small budget country which has often been attacked here for its socialized medicine has produced way beyond its numbers in innovative medical and scientific technologies and products. I welcome a challenge to that statement.
This is the wrong way to go in attacking Obamacare. I have lots of problems with it.
The idea that costs keep rising because demand is unlimited is true in medicine. Who doesnt want a longer life with a minimum of suffering? Who will not devote a substantial portion of earning to that when you cant get out of bed in the morning?
Supply of new stuff will keep rising as you are willing to devote more of your paycheck to it. Less government is better because idiot politics screw up the evolution of new ideas. We still need an academic class. Who pays their salaries?
Spindok