Professor Membrane’s Modern Medicine Sideshow…

Professor Membrane


And the professor is back to lead us through the second in our series of posts looking at real, actual, modern science stories that illustrate the “we’re living in science fiction” notion. Last time we focused primarily on medicine, and specifically on different kinds of regeneration. We’re still working our way through modern mad medical science–I have a giant archive of these stories, and we’re still well in the past with this post–looking this time at some other aspects of the medical world.

Let’s start with a pleasantly gross story. You may know that throughout history both leeches and maggots have been used by different types of “physickers”. The historical idea of “bleeding” or “leeching” or blood-letting, whatever you want to call it is basically a bunch of bunk, but that doesn’t mean there aren’t cases where modern medicine can use leeches–like using them to promote circulation in tissue reattachment surgery. Using maggots to remove necrotic tissue was actually never that bad of an idea, and in fact it’s something that’s coming back to the medical mainstream, albeit with a lot more disinfecting throughout the process than in ye olde days. I kind of love that they have come up with more patient-friendly names for this than “maggot therapy“, like “biosurgery”, or my personal favourite “biodebridement”. If you have a strong stomach, you can see some video about this here–it does come with that lovely Australian accent.

Well, you say, that’s cool–gross, but cool–but it doesn’t really count as “we live in science fiction”; this is stuff that’s been around for centuries. And that’s a legitimate point, but I’m actually only pointing out the use of biological wormy things in modern medicine to provide some context for a link to the use of nanoworms to find and treat tumours.

“When attached to drugs, these nanoworms could offer physicians the ability to increase the efficacy of drugs by allowing them to deliver them directly to the tumors,” said Sangeeta Bhatia, a physician, bioengineer and a professor of Health Sciences and Technology at MIT who was part of the team. “They could decrease the side effects of toxic anti-cancer drugs by limiting their exposure of normal tissues and provide a better diagnosis of tumors and abnormal lymph nodes.”

The scientists constructed their nanoworms from spherical iron oxide nanoparticles that join together, like segments of an earthworm, to produce tiny gummy worm-like structures about 30 nanometers long—or about 3 million times smaller than an earthworm. Their iron-oxide composition allows the nanoworms to show up brightly in diagnostic devices, specifically the MRI, or magnetic resonance imaging, machines that are used to find tumors.

Now, to be fair, the “nanoworms” in the article aren’t worm in any biological sense–they are essentially very simple nano-machines, but I figure if they’re going to call them nanoworms, then that’s an excuse for me to do the gross but cool worm medicine stuff. Stepping away from that gag for a moment, think about what that nanoworm story is saying–actual manufacturing of targeted nanomedical materials (which could have serious ramifications for cancer treatment), and this manufacturing is actually being done–and that was years ago already. If you don’t think that developing the delivery system is huge until you hear about it’s use in actual medicine, then you didn’t pay enough attention when Mr. Burke was trying to teach you something about how science happens.

(Now take a moment to think about the scary potential of targeted nanomaterials in the bloodstream that are undetectable to the immune system–bet you a dollar there’s military application research going on right now.)

Using surrogates to actually perform certain medical operations–whether it’s leeches circulating blood, maggots debriding necrotic tissue, or nanoworms tagging and delivering drugs to tumors–isn’t limited to just these cases, of course. The use of medical robots as the surrogate is something dramatically on the rise–and again, this isn’t Jetsons stuff, this is right now.

Many urologists performing prostate surgery view the precise, tremor-free movements of a robot as the best way to spare nerves crucial to bladder control and sexual potency. A robot’s ability to deftly handle small tools may lead to a less invasive procedure and faster recovery for a patient. Robots also can protect surgeons from physical stress and exposure to X-rays that may force them into premature retirement.

A generation ago, the debate in medicine was whether robotics would ever play a role. Today, robots are a fast-growing, diversifying $1 billion segment of the medical device industry

I might be showing my age, but I remember when waldoes were science fiction1

You should read that entire robot article, for the discussion of applications not just to precise control, but also to remote cyber-surgery that might allow surgeons to ‘operate’ via robot at a distance. Also the discussion of whether this technology is being disseminated prematurely.

Of course research into ways to improve these robo-surrogates also continues. Take for instance incorporation of not just manual control by a surgeon, but also automatic tracking of the surgeon’s eye movements and attention:

The team has added a device which tracks the surgeon’s eye movements. By working out precisely where each eye is looking, software can build up a 3D map of the area of tissue the surgeon is looking at. “What that does is it uses the surgeon’s brain as a way in to calculating the depth of the tissue,” said the surgeon Lord Darzi, who heads the centre and is a government health minister responsible for improving patient care.

This 3D map is allows the software to stabilise the image of moving tissues such as a beating heart to make surgery easier. It means that what the surgeon sees in the viewer is stationary, while his or her instruments are in fact moving up and down in train with the organ.

Or the incorporation of augmented reality techniques into the surgeon’s display:

This allows the surgeons to see beyond the surface of the tissue to the structure they are operating on, for example a tumour or a blood vessel. The software does this by combining the image from the live tissue with scans taken before the operation of the area. The system’s computer graphics give the illusion of see-through live tissue, with the position of the tumour beneath.

“It shows you the tumour in relation to its anatomical structure,” Darzi said. That means the surgeon can be more precise and avoid cutting out large amounts of healthy tissue. “

(Now stop for a moment and think about all those augmented reality iPhone apps. In a few years does something like your personal pocket computer have the ability to do this kind of display? Hello medical tricorder.)

And, of course, the robot can also be used to reduce operator error:

The team is also working on setting up virtual “no-go zones” such as a healthy blood vessel, which the robot will not allow a surgeon to cut by mistake.

Some of the ideas here probably do seem science-fictiony–if your visual is a tiny robot doing heart surgery at the direction of a doctor working with a crazy 3D movie interface–but if you think about something like laser eye surgery, the notion of machine-surrogate delicate procedures suddenly seems very work-a-day. And that surgery might be the best example of just how much we live in science fiction and take it for granted. Robots fire precision LASERS into your eye! And it’s an outpatient procedure that miraculously fixes your vision. Think for a moment about how mad that really is.

  1. Note: I am not in the least interested in arguing about whether or not that story is science fiction.or fantasy or some other genre label.(back)

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Creative Commons Attribution-NonCommercial-ShareAlike 2.5 Canada
This work by Chris McLaren is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 2.5 Canada.