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Monthly Archives: February 2015

The best thing about living in 2015 is that the horizon isn’t so difficult to imagine. Much of it is already in progress. Drone delivery, bionic reconstruction, restorative genetics, cryptocurrency, ubiquitous communication, rail and air travel shrinking the world as fast as the railroad shrank the Wild West. The years 2015-2050 are going to be momentous.

For most of the twentieth century, the year 2015 was muddy, nearly invisible — a mystery to most everybody. Looking back change was stagnant. The rock-your-world part of change that came from the Internet and cell phones in 2K took a century to happen. Who can wait that long?

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Change is accelerating. Medicine will open up. Traditional publishing is disappearing, banks and banking as we know it will crumble, and a new economy will replace it. Payments across borders will be thrashed out. In the next 15-30 years a transition is taking place that will look like the stagecoach-to-jet era. Society will upturn and we’ll hardly notice it.

Medicine is medieval, now. Law enforcement is tilted, off kilter. Our balance of power is sideways. Medicine is confining, medicine is time consuming, and bankrupting. Commercialized. It is not especially about healing. It’s more about a self-perpetuating industry that is vital to each of us, that we can’t avoid. Law enforcement and medical communities are similar. In each we have unquestioning and unquestionable priests who preside over our health and well being.

Where is medicine going? Will drones mean the watchers are watched, too? Very small drones made from self-assembling nanobots or maker machines will mean a ‘press’ in everyone’s hands. I see a shakeup of society, but only initially will it seem so. The future within the next 15-30 years ill amaze and confound the ones who live through it, but those afterward will look at us like the Pennsylvania farmers lugging their produce to market in a horse and buggy. Amish travelers.

Will the future’s children see us as naive or maybe stupid? Or in their eyes nostalgic, a beautiful civilization like ancient Egypt, but a bygone place, a Stranger in a Strange Land? Or will they grok the experience? Know us intimately because of all the bread crumbs we’ve left behind?

Nanotechnology with its self assemblage is set to rock the medical world and worlds we haven’t imagined, yet. Combine it with genetics, microfluidics, and we have instant diagnosis and maybe instant treatment. Cloud data? Will the cloud survive? I wonder. And maybe one other area will advance, linguistics and self definition. Perhaps if we had agreed upon usage for words like journalism, perhaps if that word were defined, we’d know how to define ourselves. We are cursed and blessed to live in interesting times.

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I see drones for peace. I see the drone dominating our national conversation. I see a thinning opacity, like smoke clearing at our periphery. I see a drone revolution, and a revolution in medicine trailing behind that.

Here, in the US, I see the unthinkable. Drone warfare on our soil. Skirmishes, really. Whack-a-mole attacks, but by then drones will be such a part of our lives that we won’t give them up; they’ll be comparable to the microwave oven in their ubiquity and usefulness so that we’ll deal with it.

The attacks will be sporadic at first, but because we are all in the same boat, so to speak, the attacks will be neutralized before they begin, brought about by amateurs who band together to assure that drones for peace is a given, a necessity. Our greatest defense from foreign attack from drones may be something known as open source defense.

And in the business of medicine, drones will compress time. Intolerable waits for prescriptions will shrink. Delivery might be expedited to five to ten minutes for custom delivery for all but the most complex situations. We’ll track our prescriptions like we track Amazon packages and they’ll track us. A text or whatever replaces the text – likely encrypted – will tell us how soon to expect delivery.

Drones will be a natural followup to the non-doc visit. Microfluidics, the field that spans ” physics, chemistry, biochemistry, nanotechnology, and biotechnology,” will fast-check our blood, saliva or cells. A near future, Treki-tricorder will go deeper into our body for serious illness and prevention of further illness without a doctor’s orders. A drone-doc will sign off only on the uncommon requests.

A trauma-doc will patch us up when we are injured in accidents. Drones will act as first responders. Small drones will hover for triage, larger drones will aid in treatment or transportation of the injured, and perhaps drones loaded with exoskeletons and self-assembling splints, including pain medication, will help us escape across rough terrain with a broken bone if rescue is delayed.

Along with our drone notifications, alerts similar to weather alerts will pop up notifying us of impending illness or preventative measures to avoid a health crisis. If we are in an impending health crisis, like a silent heart attack, a drone might deliver a defibrillator, stabilizer or G-drug – a genetic drug that is individualized to our unique body, our cellular structure. The drone will deliver a custom therapy designed for one person, targeted to only one person, which will increase life expectancy for those whose genetic glitch is a high probability of a heart attack.

Of course, to speed the diagnosis,a template that has been previously uploaded with a patient’s unique genetics, will be available for prescriptions and/or emergencies. The genetic anomalies that are characteristic of our individualized selves will be adjusted at first by algorithm and when needed, be modified by a genetic craftsman.

Most common illnesses will fit within a common algorithm, which will be available on the fly to the genomic pharmacist. This might be called G-adjust – a genetic prescription written to match the patient’s genetic peculiarities. The prescription rewrites active changes in our DNA during an illness event by prescription, or stabilizes shock in injury, and is delivered nearly instantly in a rescue pack to the drone for delivery. Hospitalization maybe be required or not.

Yet, without the drone’s speed and knowledge of a patient’s whereabouts, whether on vacation or at work, the prescription might come too late. With the drone, lives will be saved. It will be a system set up on the premise of the privacy and primacy of the individual. It can be opt-out, though.

The Opt-Outs will be seen as the Luddites of the twenty-first century. There may be people who feel genetic editing on the fly is dangerous – it won’t be perfect. A small population may not respond to liminal efforts in genetic pharmacology. And of course, those who understand the history of encryption, understand that encryption is much easier to break than it is to use, that historically we have only a short interval before the prevailing encryption is eventually broken, thus some may not trust the system.

Encryption is at best a temporary answer for medical privacy, it’s undependable as a final answer to individual privacy. Privacy is smaller than freedom, it is about one individual. It wasn’t always, but the Internet has parsed it into units. As for freedom, that’s a much larger question. Freedom and privacy are like the waves and particles, both different states of light. Freedom is about a nation of people, a collective, perhaps a world of people, though privacy cannot exist without freedom. It’s a wicked problem.

Encryption is dynamic and ever changing. A small population may be among those who pioneer tools to self-heal, self-treat with the help of fast diagnostic tools, at the edge of knowledge, tools unavailable and unused by the bulk of patients. The threshold of knowledge is not for the risk averse.

Mistakes will be made as drone medicine and future medicine evolve. Knowledge will be gained, fortunes amassed, lives saved, lives lost by businesses competing to be the fastest but not the ‘bestest.’ Drones may be loved by some, even be seen in anthropomorphic light – we may name them, treat the like pets or decorate them as an extension of ourselves – drones, our new right arm. And if drone medicine is expedited then cryptocurrency will be implemented. The future of money will be changed. Slow payment will not block the process, this is a given. Besides our doctor might locate in Brazil, Germany, China, Russia, or South Korea. Our currency will need to cross borders, quickly.

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