Truly Invasive Medicine

Knock on pill-bottles, but I am someone who has had the immense good fortune to enjoy what can only be characterized as spectacularly good health.  Over the course of my full-time working career, I estimate that I missed, on average, about one half-day per year because of sickness.  Other than a bout with food poisoning, suffered in Berlin in May, 2007 (what was I thinking, eating that seafood appetizer in an outdoor cafe on a hot day?), I can't remember the last time I had any sort of illness-related shutdown. In any case, nothing that couldn't be cured by drinking a lot of orange juice, gargling with warm salt water, and getting into bed with a good book.

Yes, I realize that past performance is no guarantee of future results. But, as long as I can keep up the good health, well, lucky me.

But I am, of course, getting along in years, and it's probably just a matter of time before I am prescribed something other than the ointment I use on occasion for eczema in my ear.

So I read with interest an article in the current Economist on new "smart-pill" technologies. (And, no, the pill doesn't make you any smarter; it's the pill that's smart.)

One company talked about in the article is Proteus Biomed, developer of technology (now being licensed by Novartis):

...which enables pills to relay data about a patient back to doctors after they have been swallowed...When one of Proteus’s pills is taken, stomach fluids activate the edible communications device it contains, which sends wireless signals through the body to another chip worn as a skin patch or embedded just under the skin. That, in turn, can upload data to a smart-phone or send it to a doctor via the internet. Thus it is easy to make sure a patient is taking his pills at the right time, to spot adverse reactions with other drugs and so on.

Naturally, this brought to mind the 1960's Raquel Welch movie, Fantastic Voyage, in which Raquel et al. were miniaturized and sent in a miniaturized submarine into someone's body for some purpose or another. (You can read the plot here.) While I had remembered the vague plot outlines and, mostly, that Ms. Welch was in it, I did not, of course, recall that the submarine was named the Proteus. Never let it be said that the men in white coats lack for a sense of humor and/or history.

Other advancements underway include a pill from Philips (the electronics folks) that will precisely target the right spot to deliver drugs, and an implantable microchip from the eponymous MicroCHIPS - Yea! a Massachusetts company! (I'm such a sucker for home grown.) - that  will contain a reservoir to hold and dispense drugs.

Anyway, I'm all for these sorts of developments. Someday, after all, I may well be a forgetful old lady, wandering around looking for the slippers that are on my feet, and wondering whether I'm only supposed to take the little yellow pill during months with an R in them.

(I will go on record as saying I'm not in favor of remedies that are extraordinarily costly, with little bang for the buck, societally speaking. I really don't want to impoverish the follow-on generation so that I can manage to stay alive three more weeks, during which time I'll probably be spending most of my waking hours kvetching about how much better things were back in my day, and trying to foist some of the junk I've accumulated over the years onto my nieces. ("Hi, honey, it's Auntie Moe. No need to call me back. I just wanted to let you know that I'm Fed-Exing you the chipped plate with the sunflower on it that you always liked."))

And, while the types of smart technology mentioned in the article are all pretty cool, there are plenty of things we could be doing that may not be all that cool, but could make a difference in health, quality of life, independence, and keeping costs down.

It wouldn't have to be smart technology. Just a smarter way of doing things.

My Aunt Mary, who's 84, had a recent health scare involving the blood pressure medicine she's taking. After numerous trips to the ER, testing, and overnight stays, for heavy-duty symptoms associated with blood pressure, the problem was solved: the pills Mary was taking were the wrong dosage.

The problem was solved the old fashioned way: Mary looked at the pill bottle and said, 'hey, this isn't what I'm supposed to be taking.'

If my aunt weren't that sharp, the outcome might not have been so positive.

But you have to ask yourself whether this could have been cleared up on Day One if someone in the ER had as a checklist item:  Ask patient for pill bottle; call patient's personal physician and ask what he/she prescribed; compare and contrast.

Now, of course, everyone in my family who's heard this story - starting with Mary's kids, who lived it up close and personal - will automatically think "check the prescription" when things start going awry. But none of us are medical people, so it's not exactly surprising that a pharmacist's screw-up was not the first thing any of the lay-folks thought of.

Now it seems d'uh obvious.

How many other little things are there out there that we could be doing?

Meanwhile, kudos to the companies that are inventing these wonderful techie breakthroughs that are going to make it easier to be sick and/or old. (Personally, I'm hoping for the latter, but I do recognize that, my sterling luck to date aside, I may have to grapple with the former as well.)