The 22nd Century Hospital Experience
The year is 2101. You are unwell and in need of a helping hand.
In a hypnopompic daze, you roll over in bed and see your bedside clock through your dry eyelids. 6:31 am, Friday 12th August 2101. This morning feels different. The bed feels less comfortable and no amount of repositioning can alleviate a gnawing, burning sensation in your stomach. As you reposition, you feel a damp coldness stroke your face. You raise your head and notice that the pillow is drenched in sweat. An up-market light blue pillow case vandalised by a navy patch in the shape of your head. Something isn’t quite right.
As you sit up in bed, the pain intensifies and you feel that the little food you could tolerate last night might make a reappearance. You grab your iPhone Z and slide across to the Pocket Doc app. You grip your phone and hold it in front of yourself, as instructed on screen, and wait a few seconds.
‘HR 122, BP 108/68, RR 20, Temp 38.7, SaO2 97%
You require hospital assessment. Your location has been shared with the ambulance service — click next to track.’
It will be here in 6 minutes. You wince through the pain as you hurriedly change out of your sweat-soaked pyjamas. The ambulance arrives and a paramedic greets you by the door. He helps you in and says ‘Amber, take us to hospital’. The doors lock and a robotic yet genial voice replies ‘Commencing journey to hospital, please fasten your seatbelts’.
The journey to hospital takes 10 minutes — a little longer than expected due to a small group of protesters, warning of a robot take over, blocking the entrance. Upon entering, you pass through a gate where facial recognition software clerks you in.
‘Mr. John Doe, Male, DOB: 01/03/2026, Age: 75 years
Medical History: Retrieved
Drug History: Retrieved
Family History: Retrieved
Genome Sequence: Retrieved
Confusion Screen: Required
Please proceed to the infectious diseases area.’
You are directed to a small room and climb gingerly into bed. You take a minute to make yourself as comfortable as possible before a junior doctor walks into the room. He is clutching an iPad Z. He hands it to you and asks you to follow the instructions on screen. You immediately recognise the colour scheme of the app — it’s Mindset, a screening test for the elderly. You did the assessment with your GP at your last check-up. It asks you to complete a few basic tasks — popping balloons and identifying babies — and it seems happy that you are at your baseline. Once completed, you return the iPad to the junior doctor who places it on the bedside table. He explains that he needs to take a blood sample to see how your body is responding to the infection and to identify the bugs. He seems excited at this prospect, as if it was a rare opportunity for him. He prepares his equipment, wraps the tourniquet around your arm and warns you that a ‘sharp scratch’ is coming. You barely feel it. You’re preoccupied by the intense pain piercing your stomach.
The junior doctor secures a cannula in place and walks out of the room clutching four small vials of blood. Returning 20 minutes later, he is wheeling what looks like a sophisticated coat hanger and explains to you that the blood test revealed that you have E. coli in your blood which requires antibiotics to treat. He then taps away at the small screen on the coat hanger and attaches a tube onto your cannula.
‘We’re giving you antibiotics and some morphine for the pain. Your genome analysis showed that you breakdown morphine slowly, so this machine will deliver it at the correct rate. You’ll feel more comfortable soon. One of our consultants will come and see you soon to tell you what’s next.’
You thank him, he gives the coat hanger one quick check over and leaves the room. The morphine is already starting to work. You shuffle yourself into a slightly more comfortable position, reposition the tube dangling from your cannula and shut your eyes.
You are shaken awake by a more senior doctor, dressed in personalised scrubs and brandishing a small device in his hand.
‘Hi, Mr. Doe. My name is Mr. Adeyemi, I’m one of the surgical consultants. We’re here to do a scan of your tummy.’
You give a nod of acceptance as you blink yourself awake. He pulls out a pair of round-rimmed glasses — the type that your great grandfather used to wear.
‘Do you mind if I wear these glasses and stream what I see to our 3rd year medical students? It’s useful for their education.’
Again, you nod. He gently pulls up your top and applies a small amount of cold, sticky jelly. He then places the handheld device onto your tummy and an image appears on the inside of his glasses. He begins to talk, presumably to this mysterious class of medical students, using words that you couldn’t quite grasp.
After two to three minutes, he takes the device off your tummy and wipes the excess gel.
‘Mr. Doe, this scan was used to look at your biliary tree. We saw that your main bile duct is blocked and you have some gallstones, which are likely to have led to an infection. You will need an MRI scan to give us a better look at the region.’
You thank the doctor for his input. He taps on the screen by your bed and informs you that an MRI is booked for 3 pm this afternoon.
2:57 PM, Friday 12th August 2101
A small-made man in a neatly pressed shirt walks into the room, rolling what looks like an industrial floor polisher. He introduces himself as the radiographer who has come to do your MRI. He adjusts your bed and rhythmically pushes and pulls parts of the scanner until, within seconds, it has transformed into an arch around your abdomen. He asks you to remain as still as possible as the scanner does its work. Three minutes later, it’s done. You think back to the last MRI scan that you had. In 2037 after developing ankle pain from your summers playing cricket. The machine was claustrophobic, noisy and, worst of all, took an age. ‘Wow, 22nd century technology’, you think to yourself.
An hour later, Mr. Adeyemi walks back into your room.
‘We’ve seen the MRI results. It confirmed what we initially suspected. You have a biliary obstruction and you have gallstones. But we also identified a likely pancreatic cancer. This is nothing to be immediately concerned about. We would like to perform surgery on you tomorrow morning to remove your gallbladder and replace the damaged piece of bile duct. We will also be taking a piece of your pancreatic tumour so that we can commence you on Omega treatment. Does that make sense so far?’
This is a lot to take in. You were fine just yesterday. Now, you have gallstones, an infection and cancer? You think back to your dear grandmother who died a slow and painful death from cancer back in 2039. Cancer is barely talked about now though. A relic of the past. You enquire about what the operation will entail.
‘I’m on leave tomorrow but one of our top surgeons in New York will operate on you through our robot. She will make two small holes in your abdomen and carefully cut out your gallbladder and bile duct. She will then implant a piece of bile duct that we are currently printing in the lab using stem cells from the blood test we did earlier. The small sample that we take of the pancreatic tumour allows us to create your Omega profile. Have you heard much about this?’
You feign a nod of understanding, so as to avoid looking naive, and thank the doctor for his help. The rest of the day passes idly by, watching programmes on your bedside TV and engaging in frivolous small talk with passers by.
7 AM, Saturday 13th August
You wake up and perform your morning ablutions. The pain has, near enough, disappeared. The personalised infusion of morphine and antibiotics must be working. Soon afterwards, a porter enters your room and wheels you down to the operating theatre. You are greeted by a friendly anaesthetist who confirms your details and consents you for the procedure. He confidently mixes vials, draws syringes and inserts another cannula in the blink of an eye. He asks you to count down from a hundred.
‘100….99…..98………97……………96…………………………’
The next thing you know, you’re staring at the ceiling in a surgical ward. You feel an eclectic mixture of fatigue, confusion and dull pain. You raise your hospital gown and look down. There are two small dressings, smaller than the palm of your hand, on your abdomen.
You catch the eye of a junior doctor on the ward — the same one who took care of you yesterday.
‘Oh, Mr. Doe, you’re awake. How are you feeling?’
You let out a hazy groan and explain that you feel groggy.
‘That’s to be expected, Mr. Doe. It’ll get better. The consultant in New York said the surgery was uneventful. She removed the gallbladder and replaced the damaged duct with a stem-cell grown graft. She sampled a bit of the pancreatic tumour and it’s currently with the lab to create your Omega profile.’
You finally summon the courage to admit your naivety and ask for more information about this ‘Omega’ they keep talking about. The junior doctor looks at you confidently — he’s glad you asked.
‘The lab will identify proteins on the tumour cells that we can use as targets for our nanoparticles. We also sequence the tumour cells to identify the genetic mutation that caused the cancer. We can then use the nanobots to deliver some genetic machinery that will correct the mutation and resolve the cancer. It will be given to you as an intravenous infusion later today.’
‘If only this existed when grandma was around’, you think to yourself. You thank the junior doctor, and curl up in bed to sleep off the residual effects of your anaesthetic.
Later that evening, the junior doctor returns with the same coat hanger-type contraption that you had seen yesterday. He is holding a glistening tube of clear liquid. He meticulously confirms that the details on this tube are correct before hanging it up and connecting it to your cannula. He stands by you as the infusion gets up and running — a precaution, in case of a reaction, he tells you.
You complain about the stickiness of the dressings on your abdomen and he agrees to remove them for you. Underneath, you barely see a scratch. He explains that the sutures used were also grown from your own stem cells and are designed to integrate into your tissues.
Thirty minutes pass. You make small talk with the junior doctor and find out that he’s fresh out of medical school. That must be why he keeps showering you with facts.
An ambulance is arranged to take you back home. The doctor discharging you explains that the GP will arrange a home MRI in two months to confirm that the cancer has regressed.
You thank the doctor and ask him to pass on your thanks to all the staff that took care of you. The nurses, the junior doctor, Mr. Adeyemi and the aloof surgeon from New York. You step into the ambulance.
‘Amber?’
‘Yes, Mr. John Doe.’
‘Take me home.’
