Today’s Medical Care: Like Star Trek’s Sickbay
Treating eye cancer with an invisible beam of protons: Star Trek or U.S. health care?
April 3, 2010 - 12:00 am
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.