Imagine there’s no hunger, or disease too

I was just reading an article about a new blood test that can diagnose a stroke in less than 10 minutes. in the comment section of the article, there is specific reference to using such a test  as a point of care solution.

The concept of point of care is that a test can be run on the spot, physically close to the patient, so that results are as immediate as possible, and do not require physical transfer from one location to another. Of course, these days, as most medical labs become fully computerized, it is possible to retrieve results via a computer terminal. In practice, though, it is amazing how often a result can already be available, but the treating physician does not see it for a significant period of time.

Of course, a properly designed electronic medical record system [EMR] should push the result to the doctor immediately. In practice, very few EMRs actually do this, and many doctors do not like to be “inundated” by lab results. This is, of course, a pathetic and ridiculous mindset which could literally cost the life of the patient, because the doctor is either too busy or forgetful to check a critical result. There are definite solutions to this [such as the doctor indicating the desire to be immediately informed of a result, at the same time that the doctor orders the test]. But unfortunately, bureaucracy, lack of vision, primary focus on profit and other  unjustifiable reasons interfere with the maximal usefulness of many EMRs.

This particular test, to rule out stroke, is as important, if not more so, than the tests presently used to rule out heart attacks. It may sound strange, but there are many people who would prefer dying of a heart attack rather than living through a stroke. The unique problem with a stroke is that it renders most patients physically and mentally limited. It literally robs the person of the ability to partake in life and to enjoy its wonders. Of course, with ideal care, many people can significantly recover from a stroke and return to significant functionality.

Unfortunately, we do not live in an ideal world. I know for myself, that if a patient of mine was to suffer the full negative effects of a stroke, all because of the fact that I did not check a blood test result quickly enough, I would likely resign from medicine. There are certain mistakes that truly are unforgivable. Robbing a human being of any meaningful quality of life all because of one’s own failings, should be too much to bear  for most doctors.

Personally, as I see more and more point of care tests becoming available, it begs the question of how much can be diagnosed at the ultimate point of care – in the person’s home. Let’s take this concept further – let’s have a system for point of care evaluation that is physically internalized in the patient. That means that 24/7, there is something physically inside of us that is constantly checking to make sure that our hearts are functioning properly, that our brains are not being damaged, that our livers and other internal organs are operating at normal levels and so on.

The ultimate point of care test would be one that identifies the first cancer cell at the moment that it appears. Imagine receiving a message from your mobile phone that a lung cancer cell has just appeared in your body. With a click of a button, this information is immediately passed over to your primary treating physician, and within a few days, you are already receiving appropriate care to eliminate the lung cancer that is still in its earliest stages.

This is by no means science fiction. I expect that such devices and mechanisms for monitoring our health will become available within the next 20 to 30 years. I also expect that these testing systems will become a part of our anatomy very soon after birth. Most importantly, they will not be seen as a foreign invasion by Terminator-like technology. Rather, they will be welcomed, like vaccines that spare us the intolerable tragedy of dying from such diseases as polio and measles.

There are already research-lab-based systems that are the size of our blood cells and that are functional enough to do critical tasks that would eliminate diseases from our bodies. Once again, time from proof of concept in a lab to integration into standard medicine can take [far too long, but approximately] 20 to 30 years. I personally pray that the same miracles that the exponential growth of medicine has generated, will cut this number down to 10 years if not less.

I want to end this particular blog post on a philosophical note. I personally believe that within 100 years, we will think ourselves as close to the gods as possible. We will not age, we will not deteriorate, we will not get sick, we will not hunger, and we will think ourselves truly above all living things, not only on this planet. It therefore is very reassuring to me that there was the recent announcement of an amazing discovery that jibes with historical elements of the Old Testament.

A recent discovery of an ancient stamp makes reference to the kingdom of Hezekiah, somewhere around 2700 years ago. As more and more archaeological evidence effectively proves the historiography of the Old Testament, it strikes me that we were destined to be reminded of our origins, just as we make our first steps into a future of biblical proportions.

There is the well-known phrase that a person cannot know where he is headed without knowing where he has come from. It seems that we are destined to become more grounded in our history, just at the time that we are making our own grand history. Of course, all of this could just be coincidence. But as Albert Einstein so beautifully said “coincidence is G-d’s way of remaining anonymous”.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.