The Cyber-Truck-Nurse-Driver Will See You Now
The on-wheels EV Precision Wellness & Longevity Clinic POC project
When creative writing students imagine what’s next in healthcare
Patrick Merel, a French biologist and health-tech evangelist + all-things-genomics geek (see his LinkedIn page) is thinking to implement what my students and I once read from a science-fiction book published by MIT Technology Review, in the Twelve Tomorrows collection, I believe it was in the 2014 edition: general practitioners (GP), ER docs and nurses driving around, accepting patients, like a clinic or hospital doing on-wheels, sorry, I meant to say, on-call services. A mobile hospital, like a mobile phone, health tech with the iPhone was in the air at this time, I can clearly remember this short story, found it rather funny — on the side of made-in-dystopia fun. In short, I found it more captivating than sustainable. The author(s?) were onto something, but as readers we mostly failed to connect the dots. I recall the students saying it was a fun way to ask us:
What are we going to do now that we know for sure that the healthcare system is suboptimal, inadequate, scary, dangerous etc., leaving whole populations underserved, with no GP etc.? In France, millions of people have no access to a GP, meaning no access to specialists, as French GPs are the gatekeepers of all medical specialties. If you want to see a GYN because you have a lump in your breast, or need to see a dermatologist as soon as possible, but have no GP, good luck!! Alternatively, you can wait for ages and eons at the hospital to see an ER doc. And if you do have a general practitioner, you will have to make it quick, like he is double-parked: only 15 minutes per patient! In the waiting room, however, it’s stop-and-go traffic.
Almost a decade later, coming to think of it, Merel’s biz plan has potential:
A sustainable on-wheels EV Precision Wellness & Longevity Clinic
The concept: the driver of this truck will also be a nurse, and with a sample from your blood she will run a whole bunch of multi-omics tests, on the go. No full-body scan, but super-early detection of cancer, for ex., for everyone… New modalities in cancer diagnostics and monitoring are being implemented, seems like it’s time to put the double-parked MD and their damn jammed waiting rooms out of business. The stethoscope era is over, guys.
Dear Elon Musk dream-team…
… if biologists from Abu Dhabi wanted to set up a cutting-edge med lab for longevity and wellness (genomics included) in one of your cyber trucks, would you lend them a truck for the proof-of-concept phase? The truck would criss-cross the whole Middle-East area. Upon completion of POC, my students added, Musk could market (sell) the whole: the truck with the lab inside.
Students asked French biologist Merel: “Why would a Tesla semi truck be useful, and otherwise what else can be done if we want a lab on wheels? What kind of machines would be available? What can they perform?”
Merel’s answer:
Had a meeting today with a company in Singapore: they are setting up covid detection labs in containers, so as you can see, mobile labs are trendy.
I will put this sequencing machine in my car, it is the size of a playstation, so yes indeed, very small…
Can be used to sequence the genome of ants, each ant genome storage requesting 0.3 Gigabase (Gb); not a human’s genome for sure, which would request 3 Gigabases for storage, as current standards for human genome sequencing say that you need to sequence 30 times the genome (30X) to ensure precision, so 90 Gb for a human (30 times 3). So this playstation-sized sequencing machine does not do much, but has great potential.
How’s that for evolution? Now, ready for a drive?
What I had in mind when starting this brainstorming session about DNA sequencing machines on a truck (or a car or a rover) was to imagine with the students how (exo)biologist Kelly Baldwin would go about exploring life in the water that protagonists from TV series For All Mankind found on Mars (season 3 & 4). Now, having a small seq machine inside of a Rover might come in handy, don’t you think so?
Now back to today, non-fiction mode: a multi-omics clinic or lab in a Tesla Semi truck, ok, cool, but what for, and what’s the biz plan anyway?
Back to TII’s Patrick Merel (Abu Dhabi) who is asking students to stay in stealth mode regarding this idea of genomics and epigenomics lab on wheels. OK, labs on wheels do exist, of course, but that kind of lab, with all the cutting-edge and compact material to sequence genomes and epigenetics, well so far, it hasn’t been really implemented, you see. As a result, and not exactly in stealth mode, students are excited and are drafting a biz plan with Merel’s help:
“- we want to accelerate access to Precision medicine in unserved population
- we want to make genomics testing available to academics, healthcare entities that cannot afford to build their own lab or need temporary access to genomics testing for studies, special (situations, ie pandemic)
- we want this project capable to move into the field while using green energy, (tesla is very popular in the UAE) and to accommodate high temperatures of the middle east ( we will have suggestions for special nanomaterial-based paints developed at Tii).
- Having a lab on a wheel capable of doing blood markers + genome+epigenome+microbiome testing will be new.
-The combination of tools being used for that purpose will be new, and will include a new player for blood markers ( like RIP Theranos, but more serious science)
Epigenome+whole genome sequencing testing in a truck has never been shown. And we are anticipating, after demonstration, to be capable to return the results after 3hrs only (world record is 7hrs today).
And last but not least, in case this project needs financing, Tii could co-fund and co-share revenue if IP creation.”
Recurrent testing: the logistics of Precision Genomics Medicine
Patrick Merel :
“As for the lab in a Tesla truck, it is needed as tomorrow’s medicine will have to get to patients, rather than sending them to hospital. Precision medicine will be based on recurrent testing, like you will need to have your microbiome checked and analyzed every (other) week, of course if you ask that patients go to hospital on a weekly basis, you will have a hard time (and the hospital is not ready for this). Better yet: deliver the lab to their doorstep.”
As my GP puts it: prevention is key in many diseases, especially for diabetes, cancers. Early detection means you might get a cure. Late detection could be a death sentence, or advanced renal disease if you have been suffering from undetected diabetes for years. Interested in having your microbiome etc. sequenced?
The logistics of Genomic Precision Medicine: data transfer, lab on wheels or wheelness clinic, drug manufacturing — disconnected from the blockbuster model of Big Pharma (India, China, etc), synthetic biology: engineering organoids to test in vitro treatment efficiency before you treat patients.
Re logistics: having petabytes of data transit via AWS (Amazon’s cloud service) is way more expensive than mailing 1µg of DNA that would have a storage capacity of 100–500 petabytes of data, all you need is an enveloppe and a stamp! This method is promising; however not yet ready. Data reliability, storage (half life of DNA in Imagene capsule is 50,000 years, so you won’t see any mutation that soon 😇), data access speed (reading and writing): these are the requirements of an efficient data storage. Then you need to benchmark your data storage-in-DNA service with other data storage technologies.
And will we be able to get the whole package from this wheelness clinic, that is: DNA sequencing, epigenetics, microbiome, blood tests +++, diagnosis (like Nebula Genomics company is offering, for instance), including the production of precision medicine treatments (drugs, vaccines)? 🧬🩺😅😅😅
Merel’s answer: “Drugs and vaccines, I don’t think so. Cell culture in a truck is gonna be real wild 🤓 What can be achieved though is a pretty accurate precision medicine appraisal for each patient: blood tests, microbiome, whole genome sequencing, but no metabolomics or mass spec, NMR spectroscopy, as those wouldn’t fit in a truck 🤪”
Finally, what are the tech specs of this truck that we need to implement the project?
“Pretty much straightforward: air cond, a lot of plugs for all the electric material, high speed internet to accommodate and enable data sharing with an AI that will process, analyze, interpret the results, before the truck resumes its journey…”
I would like to thank some of my creative writing class students, trying to imagine the world tomorrow — their world. We have been writing a SF saga for over a decade, Genomics Asteroid. And they grew quite fond of this on-wheels EV Precision Wellness & Longevity Clinic POC project…
Catherine Coste
MITx early MOOC adopter, Creative Writing Teacher
Elon Musk School, CA, USA / SpaceAix, Aix-en-Provence, France
