Sunday, March 13, 2005

Medicine in 2030

Charlie is an 83 year old man who presents with chest pain and dyspnea. His pain is sharp, pleuritic and right sided, primarily in the right infra-axillary area. The chest pain has been present for several months, gradually worsening, and has now reached the point where he can't take a satisfying breath. Charlie has no history of pulmonary or cardiac disease. He has lost 30 pounds in the last several months.

He has used OTC analgesics with moderate relief.

His past medical history is significant for Type 2 diabetes mellitus, cured 5 years PTA with nano-treatments.

He smoked for 40 pack years, quitting in 2010.

He is married and his wife, 80 years old, is in excellent health. Charlie has 2 sons in their 60's, both healthy status post cure of hypertension. They are on no medications and have not received any recent nano-treatments.

His review of systems is negative except as mentioned in the history of present illness.

The physical exam revealed a man in NAD, comfortable appearing except for an occasional wince with respiration. Lungs were mostly clear to auscultation except for fine rales in the right axilla. The balance of the physical exam was normal.

For diagnostics, Charlie's physician injected him with one milliliter of a milky white fluid. Immediately, millions of tiny molecular computers fanned out through Charlie's body, interrogating each cell's DNA. The particles, many times smaller than the nuclei of each cell, crawl along the DNA of each cell, looking for errors. Others measure the concentration of every chemical and cellular element in Charlie's blood.

When Charlie returned the next day, a technician inserted a sample of his blood into the Diagnostic TX210 analyzer. Thirty minutes later, Dr. Milton was counseling Charlie about potential treatment for his lung cancer.

Later that day, Charlie received another injection. This time, the nano-computers in the milky fluid were controlling nano-sized molecular repair machines. Directed to the right location, the repair machines quickly penetrated the membranes of the malignancy.

Each nano-computer controlled crawlers that analyzed the DNA atom by atom and compared it to a known normal. This normal was determined by reading strands of DNA in Charlie's millions of cells. Each strand may contain a small error, but by reading millions of strands, the computers were able to determine the correct structure for Charlie.

As each error is found, the crawlers called for repair machinery. As the machine attached to the DNA molecule, arms reached for the error and grasped on either side. Another arm came in with a molecular cutter and removed the mistake. Yet another arm reached into a container of repair atoms and inserted the correction. The crawler moved on down the strand.

Some of the cells were simply deconstructed. As the machinery broke the cells down to the basic chemicals, these were supplied to building machinery that performed repair and new construction. Based on the known structure of Charlie's bronchial tree, the repair progressed from the molecular to the cellular to the functional elements of Charlie's airways and vasculature.

Waste products that were not necessary for repair were excreted by the kidneys, transported there by special nano-machinery.

Three days later, Charlie was pain free and without dyspnea. He was again injected with the milky white diagnostic fluid. The next day the message was completed cure.

The future is coming.


For those interested in more info on nanotechnology and nanomedicine, I recommend this book, Engines of Creation by Eric Drexler or this site by Robert Freitas.