Monday, 23 March, 2015

Words by Ambica Golyala, Illustration by Lucy Hunter

The room is white and sterile. Month-old flowers wither in a vase, a feeble attempt at colour. A heart-rate monitor hums obediently at the bedside of the sickly patient. Doctors rush past the open doorway, weary-faced, papers flying, stethoscopes swinging, barely casting a glance toward the fading lifeform inside.

Medicine today has come far from the days of Hippocrates of Kos. Humans can perform complex surgeries, and diagnose and treat a host of ailments with consistency and accuracy. As quality of healthcare has increased, so too has the average life expectancy.

This has left the healthcare system overwhelmed. For the first time in human history, doctors and health workers flounder as population numbers rise and age-related illnesses reach unprecedented levels. Illnesses that were unheard of 200 years ago include Alzheimer’s, dementia, strokes, and hip and knee replacements. The demand for healthcare has outstripped supply.

By 2030, 22% of people in developed countries will be over 65 (nearly double the figure from 1990). Half of Australian adults already have a chronic condition, such as diabetes or hypertension. Last year the UN held its second ever health summit, warning the world about the rising toll of chronic diseases.

The past 150 years have been the golden age for doctors. A medical school graduate is bestowed with a universal badge of respectability. Not only do they make a living, they save lives. But are these waves of wheezing, walking-stick brandishing patients affecting the efficiency, and status, of doctors? They certainly no longer have the time to really get to know each individual patient.

It is clear that humans are no longer equipped to battle the world’s health demands. Will robots become the answer? Google have wheeled out a driverless car, and robo-cop prototypes are already fighting crime. But would you trust a scalpel-wielding robot? It might conjure an image of Star Wars’ R2-D2 in surgical scrubs, but medical robots today are more like highly precise hand-held instruments. “The robots don’t do any of the surgery themselves,” says Tony Belpaeme, professor of cognitive systems and robotics at Plymouth University.

The Da Vinci Surgical robot is already widely implemented. The doctor makes the decisions, such as how much of a brain blood clot is to be removed, which are executed by a computer-controlled needle. Pretty nifty. But for the moment, all they do is make the doctor’s job easier and allow access to hard-to-reach body parts. They are not autonomous, or free to roam the hospital.

But we shouldn’t scoff at the lack of automation; they still perform with incredible computational efficiency, and almost no complications. The lack of automation is purely due to the technical challenge of endowing robots with human judgement. There is also the lurking fear of legal action if something went wrong – who would be held responsible?

Doctors will no longer be bogged down by the physical demands of surgery, which are rarely discussed. Surgeons are now trying to adjust to the luxuries of food and sleep, bewildered and hardly daring to breathe a sigh of relief.

A well-fed and well-rested surgeon is emotionally stable and less error-prone. This means improved physician competence, greater concern for patient progress, a more rapid patient turnover, shorter hospital stays, lower chances of catching hospital infections, and ultimately improved patient and physician satisfaction.

The cautious introduction of robotized elements to the hospital environment has been a success. The big question now is: will medical robots develop in functional ability? Will they go the whole hog? Could they become completely automated, and gradually take over the entire healthcare system? Will doctors slowly, but surely, be weeded out of the medical field?

Probably not. Human empathy is an integral part of the doctor-patient relationship. In times of stress and anxiety, we search for reassurance in the face of another human being. Robots simply cannot provide this raw compassion, a hardwired and uniquely human quality.

The future of medical robotics is exciting. Researchers today have their heads down, developing the next generation of surgical robots to set bones, destroy cancers and more. But there will always be a place for the tender concern of human hearts and hands.