• Current Issue
• ACP Hospitalist Weekly
• Supplements
• Blog
• Archives
  • By Topic
• Career Connection
• Subscribe to RSS Feeds

A leap forward

From the July ACP Hospitalist, copyright © 2009 by the American College of Physicians

By James S. Newman, FACP

Life was fairly dull on Ganymede-13. I sat in my small bungalow on the edge of a vast forest of genetically engineered bamboo, looking at several foot-long segments of the plant. My supervisor, Johnston Addams, considered my hobby an aberration. Why would anyone want to make something by hand? His hobby, Denebian whiskey, seemed much more traditional.

I was no neo-Luddite. I enjoyed using technology, and my work depended on it. It was hard to do anything that was not completely dependent on technology in the year 3012. But I also enjoyed the feel of a blade in my hand. The bamboo had been imported to use as shipping material, its weight-to-strength ratio ideal for space flight. For me, however, segments became beautiful flutes, which I had been successfully selling on GalaxE-bay to supplement my measly MedTech-7 salary. Whittling and playing the instruments was my form of therapy.

I had not always been a MedTech-7 on a backwoods planet. Two annuals ago I was on Old Sol-3 in an advanced training program, a MedTech-15, one level short of MasterMedTech. It all went wrong and I suppose it was my own fault. I was rewiring a dated Diagnostitron, putting in a nonhumanoid modifier and scrolling through virtual acres of code, when I came across an interesting file. It was an ancient version of the Diagnostitron algorithms, as well as a full copy of the Panaceon therapeutic system. Both of these programs were heavily protected, and possession of them was considered a felony.

I should have turned the programs in, but curiosity overtook common sense. I studied hard to comprehend the material. I was a high-level MedTech, but I realized then that I knew little about what was going on inside the system, and even less about the patients. When I eventually reported my find, I was demoted and relocated, but it had been worth the glimpse.

A MedTech-7 was still a MedTech, but the reality of my job was keeping the local outmoded Diagnostitron and Panaceon clean, stocked and operating. Patients would come in and interface with the system. A series of mysterious bodily measurements were made, and a treatment plan put in place. A cocktail of medicines was generated and automatically administered. For trauma and other unavoidable surgeries, a patient would be transferred to another facility on the other side of the planet. Ganymede-13 had an ancient DeBakey-5, which could do anything from an organ transplant to a hip replacement. I never touched a patient. In fact, the thought of actual physical contact made me mildly nauseated. The equipment, despite its age, worked well, though lately the entire planet had been plagued by power outages, and the Diagnostitron had actually shut down for five minutes one month ago, a scary experience.

It was a quiet morning until the door to the clinic suddenly swung open, and in staggered Johnston Addams, looking unwashed and pale and stinking of whiskey. As I powered up the Diagnostitron, a dull boom thundered from the direction of the factory complex, and the clinic was plunged into darkness. The emergency lights did not come on. I sat in the darkness for minutes, with a sense of terror. I might have sat there longer had not I heard the sound of a body falling to the floor.

I dragged Johnston out to the field in front of the building, where at least it was light. Alarms sounded somewhere in the distance. Johnston seemed to be having trouble breathing and was covered in sweat. What could I do without the treatment system? I thought back to the information I had read on Old Sol-3. I had to remember what I had learned about “vital signs.”

I touched his skin; it felt cool. It was probably not an infection. He was breathing hard and fast. How could I assess his heart? I laid my finger gently over his wrist but the pulse did not seem regular. How could I know what was going on with his heart and lungs? I tried to undo his shirt and lay my ear against his chest, but he pushed me away.

Suddenly I had an inspiration. I ran into my office and found a half-made flute. I placed one end on Johnston’s chest, the other by my ear. I could hear his heart! I could hear his lungs! It was incredible. Had anyone ever done this before? I was actually listening to the inner workings of his body! The heart was beating so fast and very irregularly. I had no idea what it meant, but it opened up a whole new world in diagnostics. I had made an unbelievable discovery.

The power came back on, and I helped my supervisor into the clinic. The machines booted up. The Diagnostitron made its pronouncement: atrial fibrillation from alcohol toxicity. The Panaceon administered a cocktail of HeartSlow and Vitamix, and soon Johnston began to look better.

Two weeks later, I was sitting in front of a tribunal. I had been accused of experimenting on a patient, making unwanted physical contact, and betraying my oath as a MedTech. I revealed my discovery, which I called the ChestScope. We did not have to depend completely on the machines to tell us what was going on inside a patient’s body. It would be a renaissance for medicine. This would be our new golden age.

The board deliberated for less than five minutes. And that is why I am on this transport vessel, headed for the outer ring, a lowly MedTech-2. But I am not upset, far from it. I’m going out into the wilds where there will be little supervision. And in my bag there are 10 pieces of bamboo.

Dr. Newman is a hospitalist at the Mayo Clinic in Rochester, Minn., and editorial advisor to ACP Hospitalist.

Top

Hospitalist Archives
Quick Links

ACP Hospitalist Weekly

From the September 1, 2010 edition

• Statin prescriptions at discharge increasing in patients with intracerebral hemorrhage
• Black and low-income patients more likely to leave hospital against medical advice, be readmitted

View issue

Cartoon Caption Contest

This issue's winning cartoon caption was submitted by Patricia J. Peterson, FACP, in practice in Longview, Wash., who will receive a $50 gift certificate good toward any ACP product, program or service. Thanks to all who voted!

"Did you say you were a little horse? Or a little hoarse?"

Register Now For Your ACP Fall Chapter Meeting

Test Your Medical Knowledge on Your Mobile Device with ACP’s Doctor's Dilemma™ Game!

© 2010 ACP Hospitalist and American College of Physicians

ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated