Science Fiction Becomes Science Fact: Medicine
(This blog post is a deeper dive into a speech I recently gave at the Biogen Tech Symposium on the Future of Medicine in Cambridge, MA on December 16, 2015. See above video)
I’m endlessly fascinated by the idea of science fiction influencing science fact; the phenomenon of artists, writers, filmmakers and dreamers imagining a future, that eventually comes to fruition. In a previous blog post, I discuss this concept in depth, with endless examples from literature. I’d now like to explore recent medical innovations — -truly groundbreaking developments — -that were predicted and imagined years ago in movies and television.
To begin the discussion, let’s start with the notion of a science fiction feedback loop. The loop is built on the foundation of a technologic climate. That is, society’s appreciation for and understanding of what is currently feasible by today’s technologic standards. Science fiction that leaps too far ahead of our level of comprehension creates confusion. The sweet spot for sci fi, is where the science future and the science present blend together.
Step 1 begins with the science fiction being created by artists, writers, and filmmakers that reflect the current technologic climate. Step 2 is where the science fiction gets absorbed into the technologic climate (the public sees the film, reads the stories, etc). Step 3 is where new technology is created, which then impacts the current technologic climate. Finally, step 4 is where this new, advanced tech climate inspires the collective imagining of a new generation of artists, writers and filmmakers who then repeat the cycle to step 1 again. This is an endless loop of inspire, create, repeat.
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Virtual and Augmented Reality
For generations, television and film audiences have been watching characters wear glasses or visors with ‘special abilities.’ From James Bond’s x-ray glasses in The World is Not Enough, to Bruce Willis’ virtual reality goggles in Surrogates, we’re all familiar with the science fiction of magical lenses opening up portals to make the invisible visible. In more recent years, holographic images no longer require special glasses to view. Films like Iron Man and Avatar present characters fully manipulating 3-Dimensional images in space. The show Firefly even depicted holographic surgery.
Today, surgeons in Israel are using live-action 3D holograms of their patients’ beating heart to help them operate. The Fraunhofer Institute has an iPad app for liver surgery which puts a 3d vessel map on top of live video of a patient showing where its safe to make incisions. Google glasses are being used in Surgical procedures, here shown assisting surgeons at Ohio State University. Sony’s HMZ-T2 head mounted monitor is worn by surgeons while performing laparoscopic surgery using 3d compatible endoscopes.
Newly released, the VIVI Hud was designed to instantly deliver info such as vitals to doctors as they operate. The Anatomage Dissection Table uses 3-D virtual images of the human body using real CT scans to piece together a full representation of the human body which is currently being used in medical schools for educational purposes. The Eyes On from Evena incorporates “multi-spectral 3D imaging” to make veins show up when viewed via the glasses’ dual cameras. The iKnife is a high-tech scalpel that can differentiate between cancerous and non-cancerous tissue as it cuts.
Body Scanners & Wearable Sensors
Readers and audiences have been very aware of technologically advanced wearables as early as Dick Tracy’s watch to Michael Knight’s watch that he would use to communicate with his supercar KITT. Even James Bond had many examples of ‘smart watches’ throughout his films (shown here is the Goldeneye watch which was a combination laser cutter and bomb detonator). One of my favorite examples of a wearable is the show The Greatest American Hero (brilliant show that should NOT be remade and ruined) depicting high school teacher Ralph Hinkley finding an alien suit that would give him superpowers whenever he wore it — without it, he was just an average, ordinary guy. As for famous sci-fi body scanners, the best example is the Star Trek tricorder.
The device that comes closest to that vision is the Scanadu Scout which is touched to a patient’s temple and returns key vital sign results in less than 10 seconds. Theres the Biosign Health Monitor Pulsewave™ MAX which uses four channels of incoming data to measure up to 10 biological stats. The ihealth gluco meter allows you to take and log measurements anywhere and view trends for a span of 7, 14, 30 or 90 days. Medtronic’s artificial pancreas is the first of its kind in the United States, and has the capability to automatically stop insulin delivery when blood glucose levels are either too high or too low. As for wearable sensors, there’s the smart tatoo which uses ion-selective electrodes that register the pH or salt levels of the skin to monitor an athlete’s fitness level. There’s a thermometer tattoo which is a patch that when glued to the skin can be used as a thermometer — continuously measuring skin temperature. The Pill Cam SB2 is a vitamin-sized capsule that’s swallowed allowing physicians to detect and monitor lesions, ulcers, tumors, and bleeding within the small bowel. The tooth sensor is a wearable mouth sensor that can differentiate your bad habits, and send that information straight to your dentist.
As far as I know, there aren’t any clothes that will give the wearer super powers (yet), but there are some very interesting innovations occurring in the apparel world. The Reebok Checklight measures impacts to the head and tracks directional linear G-forces. Radiate Thermal Vision makes a workout shirt that changes color according to your body heat, revealing muscular and vascular action. The Hexo Skin Biometric Shirt tracks Heart rate, Breathing rate, Steps, Total breathing volume, G forces, Cadence. Athos smart clothing is developing garments that can track people’s muscle activity and detects how hard muscles are working. Hi Toe’s clothing transmits the heart rate of the wearer using three credit card size sensors. Miraculously, just like any other clothing these can all be washed!
We’ve seen depictions of robots performing medical procedures and surgeries for many years — from Logans Run and Sleeper in the 70s, through Star Wars III Revenge of the Sith’s famous robot surgery scene with Darth Vader. A very well known robot surgery was in Promethus, using this surgical cradle. And a scene in Enders Game was actually filmed at the University of Washington BioRobotics Laboratory using their Raven II surgical robot to simulate brain surgery.
In reality, the most famous example of science fiction becoming fact is of course the Davinci Surgical System made by Intuitive Surgical which facilitates complex surgery using a minimally invasive approach, and is controlled by a surgeon from a console. The Acute Care RP Vita is the first FDA-cleared telemedicine robot using AutoDrive technology. There’s the admittedly creepy Telenoid R1 which is a human-like remote controlled android that uses an audio and movement transmitter through which people can relay messages over long distances. The DARPA Trauma Pod will enhance battlefield casualty care through the integration of tele-robotic and robotic medical systems. The Veebot is hoping to automate drawing blood and inserting IVs by combining robotics with image-analysis software. The ARES which stands for (Assembling Reconfigurable Endoluminal Surgical System) is an ingestible surgical robot that assembles inside the human body and moves through the system like a robotic snake. Of course, medical drones are being utilized to delivery urgent medical supplies during times of humanitarian crises, in remote areas.
CREATION Growing Organs & 3D Printing
In my opinion, one of the greatest shows of all time The Six Million Dollar Man (another classic that should be left alone and never remade) which told the story of Steve Austin, Astronaut/Test Pilot who had both legs, an arm and an eye replaced by bionic body parts after a tragic test flight crash. Then came the spin off of the show, The Bionic Woman, depicting Jamie Sommers who also got an arm, and two legs but instead of the bionic eye, she got a bionic ear, after a sky diving accident. Beyond organ and bodypart replacement, sci fi has more recently illustrated the possibilities of printing organs and bodyparts — -The Avengers Age of Ultron used a 3d printing “cradle” to create ‘The Vision;’ The Fifth Element presented a dazzling sequence of a full body printed one layer at a time; in the classic film Darkman our hero used cutting edge 3D printed skin to create one disguise after another to gain revenge on his foes; Star Trek presented a skin gun that could repair injuries and heal skin.
This sci fi vision of growing organs has now become reality. Using Human induced pluripotent stem cells (iPSCs) and embryonic stem cells (ESCs) Scientists are growing kidney organs in petri dishes at the University of Washington, these are now undergoing clinical trials. At the University of California in Irvine, a new heart valve has been developed that combines a patient’s own cells with metal alloy for a more durable replacement with potentially fewer complications. A company called OxSyBio is developing 3D printing techniques to produce a range of tissues for medical research and clinical applications. University College London have developed a technique to grow ears and smaller organs, such as blood vessels and windpipes using stem cells. A team of scientists from Wake Forest has grown human bladder sacs in the laboratory and successfully transplanted them into people. A team at my alma mater Carnegie Mellon University took MRI images of coronary arteries and 3-D images of embryonic hearts and 3-D bioprint them with unprecedented resolution. They printed the materials in a supportive gel.
There’s some incredible innovations with artificial limbs now being linked to the human nervous system with computers to restore lost sensory function. Neuroprosthetics and the modular prosthetic limb will help patients to feel and manipulate objects just as they would with a native hand. Just like in Star Trek, there’s now a real skin gun that sprays a burn patient’s own cells on the burn to help regenerate the skin and drastically reduce recovery time. A company called Second Sight Medical Products has developed implantable visual prosthetics that restore some useful vision to blind patients, and patients with macular degeneration — ever closer to Steve Austin. Similarly, bionic hearing is getting closer to reality with cochlear implants which are electronic medical device that replaces the function of the damaged inner ear, restoring hearing to the deaf. Researchers from Stanford have developed an artificial substitute for skin that is capable of sensing when it is being touched and sending that data to the nervous system. Researchers at the University of Wollongong have created a “Biopen” that uses 3D printing technology and bio ink to “draw” over sections of damaged bone. Scientists from Cornell University are pioneering new spinal treatments uses 3d printing with stem cells to replaced injured spinal discs — giving hope for the millions of Americans afflicted with chronic back issues (like myself!)
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BRAINS AND COMPUTERS
From the 70s film based on the Michael Crichton novel The Terminal Man featuring a procedure implanting electrodes in the brain and connecting them to a miniature computer to the 80s classic Brainstorm about the creation of a helmet that records memories and experiences, the theme of man interfacing with machines has been prevalent in sci fi films for decades. Even the recent Captain America 2’s depicted the character of Zola, as an evil scientist who uploaded his entire consciousness to a computer, this doesn’t seem as far fetched as it once did.
In the real world, Stanford has been working on a circuit board called Neurogrid that mimics the behavior of the human brain — it can replicate the processes of 1 million human neurons, resulting in computer chips that are 9,000 times faster then a desktop computer. The Muse is the first tool in the world that gives you accurate, real-time feedback on what’s happening in your brain when you meditate. Neuroscientists at Duke University have been investigating how the brains of two or more animals can be networked to work together as part of a single computational system called Brainets. British engineer Kevin Warwick, who is most famous for Project Cyborg, is known for his studies on direct interfaces between computer systems and the human nervous system, and has also done research in the field of robotics. Brain Implants are technological devices that connect directly to a biological subject’s brain to help circumvent areas that have become dysfunctional after a stroke or other head injuries. The Neurobridge is a system that allows the brain signal to bypass the site of an injury — like the spinal cord — sending it directly to the muscle that is being controlled. The Human Brain Project Europe Commission is building a completely new computing infrastructure for neuroscience and brain related research. Finally, Optogenetics is a biological technique which involves the use of light to control cells in living tissue, typically neurons in the brain, for more precise manipulation than implanted electrodes, drugs, etc.
EXOSKELETONS AND IRON MAN
From Ripley’s exoskeleton in Aliens to the Invincible Iron Man, audience’s imaginations have been open to the possibility of augmented strength and amplified abilities by stepping into a high tech suit and or strapping on some mechanical armor.
The believeability of these suits in films has only gotten more authentic, due in large part to the increasing possibility of bringing these suits to life. Companies like Rewalk and Ekso bionics are designing and creating suits to give mobility to people with paralysis. ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with spinal cord injury (SCI) to stand upright, walk, turn, and climb and descend stairs. Ekso Bionics develops and manufacture powered exoskeleton bionic devices that can be strapped on as wearable robots to enhance the strength, mobility, and endurance of soldiers and paraplegics. Defense giant Lockheed Martin has created the HULC — Human Universal Load Carrier, a completely un-tethered, hydraulic-powered anthropomorphic exoskeleton that provides users with the ability to carry loads of up to 200 pounds for extended periods of time and over all terrains. Raytheon has made wearable robotic suit called the XOS-2 increases the human strength, agility and endurance capabilities of the soldier inside it. Bespoke Innovations creates intricately & personalized designed panels that fit over prosthetic legs to reflect the client’s personal style. The Biomechatronics Group in the MIT Media Lab. aims to restore function to individuals who have impaired mobility and developing technologies to augment human performance. Finally, the company Biodapt designs prosthetic limbs to serve amputee athletes, particularly for high impact sports
We’ve seen nano technology in films as diverse as Iron Man 3 to The Day the Earth Stood Still. But the film that was the most seminal in predicting the future was Fantastic Voyage in 1966 based on the story by Otto Klement where scientists shrink down to a microscopic scale to enter the body of a scientist to attempt to repair his injured brain.
Today Nanotechnology is reality. This is a model of a carbon “buckyball,” the atomic building block for nanotechnology held up by a Dr at Cleveland Clinic, where doctors recently launched a partnership with The Hebrew University of Jerusalem to develop cures for some of the world’s most threatening diseases. The Clottocyte Nanobot functions similarly to the platelets in our blood by dispersing fibers, they create a clot in a fraction of the time that platelets do. Rice University in Texas, & MD Anderson Cancer Center Oncologists are now injecting cancer patients with ultra-tiny, gold-wrapped nano spheres that absorb light and turn it into heat to destroy cancer cells. P2i is a nanotechnology solutions provider who works with manufacturers to deliver liquid repellent nano-coating protection. The European Tech Platform is a group of 53 European stakeholder that are leading the charge toward:
• Nanotechnology-based diagnostics including imaging.
• Targeted drug delivery and release.
• Regenerative medicine.
Researchers at Rice University are combining a nano fiber hydrogel called SB50 with snake venom to create a very potent coagulant. A team of Israeli and German at the Max Planck Institute scientists have come up with the world’s smallest propeller which is huge for drug delivery and can go places larger micro propellors can’t go — -right through gaps in connective tissue mesh.
There’s truly an amazing future ahead and we’re living in a time of constant disruption. Throughout this research process and gathering these materials I shared much of it with friends and colleagues, and everyone had the same reaction — -this all seems like science fiction! There’s inspiration all around us from movies, books, stories, and remarkable innovations in other industries. I’m excited by breakthroughs cross pollinating across vastly different industries — for example 3D printing and robotic innovations helping to advance medicine. I look forward to seeing that continue and only increase. Throughout all this, we need to embrace the disruption but also keep the focus on maintaining the human touch, the doctor patient relationship. As technologic medical innovation accelerates, the human need for interactions with other humans must be retained. Its this notion of ‘soul’ that I constantly espouse in my discussions about user experiences — -the importance of design feeling organic, user centered, approachable, and avoid appearing one dimensional and cold at all costs — every detail must been carefully considered, and the human touch is visibly apparent and omnipresent.