Daily Archives: August 23, 2012

The Seductive Allure of Technology

My background includes two seemingly disparate fields – healthcare and the military. These two professions do tend to have one characteristic in common, when facing a problem, one of the preferred solutions will be technology.

The military’s march through history, at least since the 17th century, includes advances in tactics alternating with advances in technology. The cross bow replaced the long bow; the blunderbuss was next, followed by the musket and the rifle. Sometimes the leap frogging of tactics and technology created huge problems (ignoring the fact that war by its very nature is in itself problematic – at least for the losers.) In the Civil War, the rifle and the minie-ball when combined with massed attacks and counterattacks were so destructive that amputations of limbs that couldn’t be saved were rampant.

Before America entered World War II in 1941 it was heavily reliant on fabric covered biplanes. At the end of the war in 1945, America’s Air Forces were using pressurized high altitude bombers. Radar and sonar allowed the acquisition of an enemy’s position without actually seeing anyone and the computer was used to create mathematical tables essential to more accurate artillery fire. The trend in the military’s leveraging of technology continues to the current day.

In medicine, during the same period, the advances were somewhat slower. They were still bleeding sick people in the 18th century, and the first antibacterial drugs weren’t discovered until 1928. However, we’ve made up for that in the past 30 or 40 years. Although we have had x-rays since 1895, digital dependent modes like CT Scanners, Ultrasound, Nuclear Medicine and MRI Scanners all arrived after 1970. Add to that such exotic technologies as proton beam therapy, robotic assisted surgery and you have to ask why we don’t live forever.

It’s the same reason that we don’t win a war neatly, cleanly and without collateral damage in a short time.

Technology is a multiplier. Take the humans involved and multiply by the technology. Healthcare is easier to understand. Let’s pretend we’re dealing with a fractured femur – the bone between the knee and the pelvis. The patient is assigned a numerical value from 0 – 2 based on their general health and ability to survive 6 months after the surgery. The technology multiplies the effectiveness of the doctor, which then multiplied by the patient’s value

Excellent orthopedic surgeon (2), technologically advanced equipment (3), healthy 18 year old patient (2),         (2 x 3) x 2= 12

Competent orthopedic surgeon (1), technologically advanced equipment (3); middle aged patient in fair health (1),     (1 x 3) x 1 = 3

Incompetent surgeon (0), technologically advanced equipment (3); healthy 18 year old patient (2)             (0 x 3) x 2 = 0

Excellent orthopedic surgeon (2), adequate equipment (1), healthy 18 year old patient (2)                 (2 x 1) x 2 = 4

Excellent orthopedic surgeon (2), technologically advanced equipment (3), elderly patient in poor health (0)         (2 x 3) x 0 = 0

In this example, technology can allow an excellent surgeon to do better, but can’t make up for an incompetent one. Likewise, technology cannot offset the problems associated with a patient who is not a good candidate due to health problems.

The allure is that you can buy technology. Skills must be developed and that takes a certain amount of core ability and a lot of time. However, the technology never replaces the human element.

Maybe that’s why some people enjoy sports so much – it’s dependent upon a rare set of inherent talents that must be perfected by hard work. The right shoes or high tech sports drink is never going to replace those.