“ — Digital tsunami in medicine? I’m waiting???”
This is episode 15 of The French Tech Comedy Season 2.
Episode 14: Salambô’s Python (coding)
Previously in The French Tech Comedy: In Season 2 of The French Tech Comedy, we follow characters like Japanese oncologist and bioinformatics engineer Takafumi Nagato, who is leading the lab of Bioinformatics for personalised CAR-T-therapies in a Tokyo clinic, and his patient, Chinese giant TenBa’s founder Ken Ba, a zillionaire from Shanghai. Yuki, Taka’s sister, is a French-speaking geisha, meaning “artist” in Japanese, in touch with the French Tech. She just got married to a French engineer who was working in Taka’s lab, Nono, and has secretly donated her healthy T-cells to Taka’s patient who, after his second cancer relapse, decided to try an innovative treatment called “liquid biopsy”. Indeed, Ba is becoming an expert in genomic precision medicine. In his case it is a matter of life or death. Among Yuki’s friends in the French Tech branch is Frederic Mougin, a biologist, founder of the startup Gene-i-us:
“We are developing a patient-centric tool for patients to collect, share & monetize their medical, genomics, lifestyle, IoT data with academics & pharma industry.”
Yuki had promised she would introduce Mougin to people working with Facebook Singapore; among them: Nono. What biz plan can Gene-i-usimplement, in order to work with Facebook? Mougin is using a lot of buzz words, but when it turns out Ba’s cancer mutation has entered the stock exchange market, thanks to the efforts of a pharmaceutical company, his oncologist, Taka, fears a Ba Gate. More than ever, the privacy of genetic data is instrumental in the process of developing precision medicine. Singapore is the Chinese Mecca of I.P. and patents. A cryptocurrency, that is seen by financial specialists as a security, is used as a way to reward (healthy and sick) patients in exchange of their DNA data. Yuki is wondering if this kind of money will revolutionise the whole financial and pharmaceutical market as we know it, or will all digital currencies end up behaving like any other tradable financial asset? After all, a security is a tradable financial asset. Ba, Taka’s cancer patient, is trying to gain insight into the situation… While spending a few days in Malaysia both for business and vacation, TenBa’s founder gets to meet with a total stranger who in fact he only knows too well: Simone, Malaysian Chinese actress Michelle Yeoh’s niece. Between Ba and Simone, things are complicated. But it is only the beginning… Simone is trying to make an algorithmic cryptocurrency that could mimmic biological processes within the human body. Meanwhile, Manga artist Koba writes about the blurring frontier between curing and enhancing in the genomic precision medicine era, and the consequences in society. At school, Simone needs to present her Science Fair project alone. Overanxious auntie Michelle had bribed a student from Simone’s class. She wanted her niece’s science fair presentation to be filmed, live. A few days later, she sent a link to a video to a friend of hers, Chinese giant TenBa’s founder Ken Ba, a zillionaire from Shanghai. She’d compiled a 10 minutes extract for him to see, and a question:
“ — What do you think?” Ba said the video was very interesting and offered to have lunch in Ipoh, Michelle’s home town, next weekend, and discuss things. Simone, meanwhile, is stuck in Bangkok, where Ba has sent her a T-shirt as a thank-you gift, she’s not sure why. Also, as a hacker having served time in a Beijing prison, she is suffering from post-traumatic stress. In Singapore, rockstar US physician Tamir Subramanian is a keynote speaker at Facebook’s “The Patient Will See You Now” Breakfast. In the conference room nearby, a Facebook Open Day Q&A session for students from local high schools has just started. Simone is attending, she gets to meet with Nono, who ends up inviting her for lunch at the famous Facebook cafeteria. How to program a digital currency with its own blockchain, taking advantage (or mimicking) the underpinnings of the biological mechanisms of epigenetics? Simone, Nono and Yuki are trying to reflect on this. Yuki and Simone end up talking about reincarnation and video games, while shopping at Daiso, in Suntec City mall, Singapore. Close nearby is South Beach Tower, with the Facebook company at level 22. Rockstar US physician Tamir Subramanian, editor in chief of the Transversal J Med, is interviewing Geronimo Faber PhD, who is spearheading the global crusade to defeat ageing. Nono is watching the one-on-one interview, a video that was just posted on the Transversal Journal of Medicine’s website. The whole thing is boring, and Faber still needs money. Nono revamps the boring video, writing a new episode for the Japanese Manga Saint Oniisan (Saint Young Men), in French: Les Vacances de Jésus et Bouddha (Jesus and Buddha On Vacation). He is almost done, when he gets a call from the Big Boss… Zuck wants his platform to revolutionise healthcare. Koba the manga artist is writing the story of Pierre, an “augmented” patient. The manga book, for US rockstar physician Sub, is called: The Augmented Patient Will See You Now.
— — — — — — — — — — —
Jean Reno has just received a book, in his home in Aix-en-Provence, France. It’s called “Health 4.0. Digital Tsunami in Healthcare.” François Mueller, a bioinformatician and mathematician from Switzerland, wrote the book.
Bad timing, though, as French actor Reno is not happy with medicine and the health care system at the moment…
“ — Digital tsunami in medicine, really? I’m waiting???”
His friend, French actor Richard Berry, has just lost his parents, both of them. Richard’s mom Stella has pioneered live kidney donation in France, decades ago, as a “patient”: a healthy mom, donating a kidney for her daughter. Somebody needs to write the story. Right now, Reno is talking with Richard on the phone. Richard has a sister, Marie. Live kidney donation? Rings a bell. Richard has also donated a kidney to his sister, years ago… Both Richard and Marie are doing fine, today. To date, Marie has been living with one kidney from her mom, then one kidney from her brother, since she was a teenager. Live kidney donation works… A kidney coming from a “dead” patient (a “brain-dead donor”) lasts for 9 years, on an average. A kidney coming from a living patient can last for 30 years +. In France, most kidney transplants involve brain-dead donors; not living donors. Most surgeons are not willing to harvest a kidney from a healthy donor. They prefer dead donors, less likely to complain post-op… But what is brain death? Even journalists from the New Yorker today are not sure… What Does It Mean To Die?
“ — Richard does not get any particular medical follow-up, I mean, nothing specific, like some kind of annual post-kidney donation medical check-up. Maybe, at best he could get a blood test every other year. But he has to ask for it..,” says Marie, who received a kidney from her brother Richard.
Some French blogger has written an article, called “Civil Death, Brain Death, A Legal Fiction?” , where he compares brain death with civil death:
“The Code also instituted the punishment of “civil death” (morte civile), a legal fiction by which the perpetrators of certain classes of crimes were held to be legally dead. Their marriages were dissolved, their children considered orphans and the legally dead were unable to own, purchase or dispose of property.” Civil Death was abolished in 1854.” (Source: The Civil Code: an Overview.) He wrote about testimonials by families confronted to organ donation. There was a polemic, that went on and lasted for years. It still isn’t over. Doctors are asking for organs to transplant, but brain-dead patients in the eye of their significant others, or next-of-kin, are still human beings with the rights of the person; not a mere organ reservoir, a disposable enveloppe of precious spare parts that others (impatient patients, waiting for a transplant) can claim ownership of… Anyway, Marie told Reno, the question of “post-mortem” organ donation is a difficult one.
“ — Why do they even use post-mortem, in a dead language — Latin? Do they have something to conceal?”, asked someone on the blog “Ethique et transplantation d’organes” (The Ethics of Organ Transplants).
As far as Reno knew, there were a lot of unsolved mysteries in conventional medicine, a lot of medical mistakes, and a lot of dangerous and useless drugs too, but of course this was old news…
Living into your 90s was commonplace, but how about living into your 1,000s? Reno felt like his own role in The Visitors, a French fantasy comedy film released in 1993. In this comedy, a 12th-century knight and his servant travel in time to the end of the 20th century and find themselves adrift in modern society. Conventional medicine relies on repairing or replacing the ailing or failing (or sick) organ, and therefore organ transplants are the pinnacle…
“ — Digital tsunami in medicine, really? I’m waiting????”, he thought.
“In front of his 8-year-old daughter who asked him if we were all going to die, the author was cowardly: I said no. Then I told myself that I was going to try to justify this no. Frédéric Beigbeder went on a hunt for information, from the Georges Pompidou European Hospital to the Harvard Research Center, to a Geneva clinic specialising in genetic manipulation and cell reprogramming, and a medical center in Paris. Jerusalem virtuoso of DNA. Sequencing of his genome, laser perfusion in Austria … he did everything he could, except the transfer of the contents of his brain to hard disk for reimplantation on an android. The result: an intense journey in the future to the present, with a background of personal life, love and fatherhood included.”
French actor Richard Berry and his sister Marie, French writer Beigbeder… Digital tsunami in medicine, really?
Reno opened the book… He read about patients’ medical records, in the form of the blockchain.
“1.- The concept of Artificial Intelligence has a hard time embracing the reality of contemporary developments and research. Indeed, both because what currently works best in this area such as machine learning is far from being equivalent to the functioning of the brain or neurones. And yet, all the terms used by specialists directly refer to it. This maintains some confusion. Moreover, it should be understood that AI also uses distributed and even collective phenomena. Thus, rather than seeing the future of AI take shape in a humanoid, we can instead see man being enveloped in a cloud of bots (a kind of autonomous and ephemeral computer program) with the purpose of extending his sensory, visual and cognitive abilities.
We must therefore consider the future of man in a tangle of networks man-machine performing in distributed activities.
Thus the very vision of well-being, health, prevention, illness, accidents, emergencies, care, treatment, convalescence, etc. of the health system in short … will be completely revisited. We will, in a way, perform a RESET of all concepts and practices.
Let’s prepare ourselves to understand and live these new challenges.
2.- Then the knowledge will be extended to the whole world. More than 40% of the world’s scientific publications are currently produced outside the EU and the United States, especially in China. Everything that happens in the medical world, for example, will be immediately known by computers and other AI software. This flow of shared knowledge will greatly change access to information, to medical practices and allow both to avoid errors but also to avoid unnecessary medical procedures. An improvement of the system will then be possible in terms of quality but also of costs.
3.- finally thanks to intelligent software (IA) and connected objects (IoT) we will be able to analyze in real time a large number of key factors even critical for the functions of the living. Once captured and analyzed, decisions will be made. A continuous world will invade medicine. No more annual check-ups. Medical monitoring will be permanent. Another system is emerging. It will be the fact of a complete knowledge analyzed by bots at any time … but discreetly … we will be warned at the same time as the medical profession that if things are going wrong … if there is a medical emergency. Our visits to the doctor will leave more time for the essential: the human relationship, exchange, listening. Sensors and AI programs will have done most of the doctor’s current work.
Of course other aspects of this medicine will develop … but for now what needs to be done is an effort of imagination, creativity and open-mindedness to welcome the field of possible applications … Worst of all would be to do nothing, and embrace the statu-quo.” (Source)
"New technologies often appeal to young people, who are more plastic and receptive to innovations. A good example is KidsANDtransplant, a serious game computing platform created in Geneva. This great tool gives children or teenagers who got a liver transplant and their relatives access to the information needed for their medical follow-up: hospital discharge letters, consultation reports, imaging reports, laboratory results, follow-up charts etc.
Catherine Coste
MITx 7.00x, 7.QBWx, 7.28x1–2 certified
Teacher and Member of the Walking Gallery of Health Care, founded by US activist Regina Holliday
Table of Contents:
Episode 1 of Season 2: Your DNA Will See (and Mutate) Your Credit Card Now
Episode 2 of Season 2: The Bitcoin That Pulled the Double Helix Apart
Episode 3 of Season 2: Kabuki Theatre and Desktop Epigenetics
Episode 4 of Season 2: Tenjin and TenGene
Episode 5 of Season 2: TenGene, Gene-i-us and a thousand planets in between
Episode 6 of Season 2: The Re:Creators Fault Line and the Epigenetic of Worldwide Middle Class
Episode 7: The Methylation of Money
Episode 8: “Biology has gone digital. Time to learn about it.”
Episode 9: Year of The Earth Dog
Episode 10: (Zebra-) Crossing The Rubicon
Episode 11: The Chinese Student Will See You Now
Episode 12: The 11th Commandment(s)
Episode 13: Holy Trinity: Jesus, Buddha, Selfie
For Season 1 of The French Tech Comedy (all episodes), see here.
