About 5000 years ago, the wheel was conceived and deployed as a new technology. A little more than 500 years ago, the printing press was invented. 143 years ago, the telephone was patented. Only thirty years ago, the prospect of a home computer became real. Ten years ago, smartphones did not exist. Now, smartphones are ubiquitous, we can affordably sequence our own genome, self-driving cars are imminent, and Google is building a surgical robot.
The law of accelerating returns argues that the rate of technological progress ramps up exponentially as the information processing tools of prior generations are used to make those of the next. Surgeons – and therefore patients – are beneficiaries of new technologies. An era without CT, MRI, diathermy, microscopes, endoscopes, and real-time patient monitoring is hard to comprehend. Many of the operations performed today have been made feasible only by very recent advances in technology. Endoscopy, for example, would be impossible without fibre-optics bringing light into body and digital cameras enabling visualisation.
What is particularly exciting is the current pace of technological advancement. Kurzweil, a futurist and key proponent of the idea of a technological singularity, argues that the 21st century will bring progress equivalent to the previous 20 millennia. As a technology becomes more efficacious it also draws more attention, attracts more investment, and develops even faster. The likes of Google, Apple, Facebook, and Microsoft drive technology forward even faster in the constant search for a better bottom line.
What does this mean for surgeons and their patients? A world of internet-connected devices, smart sensors, deep computer learning inspired by neural networks, ever-more dextrous robots, nanotechnology, and 3D printing; surely these technologies are bound to bring benefits to human health?
Gavin Francis aptly said that “medicine can be described as the alliance of science with kindness.” Surely no technology can provide kindness? But then again, need that be human kindness? Already, online avatars are helping to treat mental ailments and the latest iPhone can recognise facial expressions. Could not an AI-driven avatar learn to be kind? Might it even be kinder and more adaptable than some humans (not so difficult if you read about the background to Royal College of Surgeons anti-bullying campaign)!
With progress so rapid, it is impossible to predict how new technologies will transform the delivery of surgical care. One thing is certain though. Today’s and tomorrow’s surgeons must embrace the change and, perhaps more than ever, be nimble so as to avoid the plight of the lamp-lighter!
Clinical Lecturer in Neurosurgery, University of Edinburgh
PS If you don’t want to be superseded by Google’s surgical robot, you’d better get yourself an eosim!