Have you ever wondered what medicine was like hundreds of years ago? It’s a pretty scary thought.

I mean, just imagine dentistry without Novocain… or surgery without anesthetic… or the kind of thing that happened to George Washington.

Washington, the first President of the United States, was more or less killed by his doctors. On December 12, 1799 — a little over two years after retiring from the presidency — Washington rode out to inspect his farms on horseback. The snow and freezing rain from the ride gave him a cold, fever and a throat infection — the combination of which morphed into laryngitis and pneumonia.

It wasn’t the pneumonia that killed Washington within 48 hours of getting sick, however. More likely, it was the shock of having five pints of blood deliberately drained from his body. “Bleeding” was a cutting-edge medical treatment back then.

As if that weren’t bad enough, Washington was further treated with calomel — a toxic mercury compound highly prized among 18th century doctors. According to science historian Christopher Koehler, calomel was sometimes given “in such quantities that patients’ hair and teeth fell out.” No wonder the man died in two days!

Ugh. Thank goodness those brutal days are behind us, right?

We are used to thinking of modern times — and modern medicine — as much more, well, modern. But on a day not so far off… perhaps a mere decade from now, by the year 2019… we may well look back on 20th century medical techniques and shudder anew.

Educated Guesswork

As of now, the number-one killer in the United States (and many other Western countries) is heart disease. In medical investor lingo, heart attack, cancer and stroke are considered the “Big Three.”

Given that the Big Three (heart attack, cancer and stroke) are such widespread killers, you would think there would be better ways to treat them by now… but no.

In some ways, our methods for handling the major ailments are only a few steps removed from the bloodletting and calomel practices of Washington’s day. The world of medicine, for all its small advances, is still in a sort of Dark Ages.

Think about it. How much do you know about what’s really happening inside your body? How much are you really at risk for heart attack? For cancer? For stroke? Most of us don’t really know… and we don’t find out until it’s too late. This is because our doctors don’t really know either.

The current practices of checking for “Big Three” risk are akin to examining a car without actually looking at the engine. Imagine if you took your sedan in for a checkup, and all the mechanic did was listen to the sound of the motor revving. Then imagine your mechanic told you “maybe” your car is at risk for a certain condition, and that you should pay for a super-expensive fuel additive to go in your gas tank with every fill-up, just in case.

Would you be satisfied with a diagnosis like that? Probably not. But this is by and large just what doctors are forced to do today. They can’t routinely “pop open the hood” and look inside your body — where the real action is — because doing so would be too invasive and expensive.

So, instead, the 20th century M.D. does a lot of “educated guesswork.” Most of the time the patient (someone like you and me) has to “break down,” i.e. experience a full-on heart attack or stroke or tumor, before he or she is really and truly treated.

It’s nuts when you think about it. If we treated our cars the way we treat our bodies, the concept of tune-ups and engine diagnostics would hardly exist. Instead we would all just drive around, putting expensive prescription drug additives in our gas tanks (based on hunches from the mechanic)… meanwhile waiting for a major breakdown to occur — quite possibly in the middle of the road — before popping the hood and getting things fixed.

A Vision of the Future

Now, imagine this alternative scenario just five or 10 years down the road.

You walk into a conveniently located medical clinic (not far from your favorite grocery store). It’s time for your six-month checkup, so you sign in and take a turn in the state-of-the-art full body CT scanner — a machine orders of magnitude more powerful than anything in existence today. (The radiation is low enough that you could do a scan every single week and it wouldn’t hurt.)

Less than a minute or two later, you step into another room. The medical technician on site pulls up a full-color, three-dimensional, rotatable display of your heart and lungs on a giant 64-inch plasma screen. The image is daz­zling. It can be turned in any direction or zoomed in with ease… almost like a giant hologram. You and the tech can see every single detail, down to the tiniest blood vessels and arteries (and any plaque buildup that might be restricting them). We’re talking your heart and your lungs, in full 3-D technicolor, from any angle you please.

So are you healthy and fit, or are there problems to watch out for? You and the medical technician don’t have to worry about making a diagnosis, because the results of your scan have been fed to an “anomaly detection program”… a special analysis program run by a super­computer somewhere off-site. This super-powerful program instantly compares your scan results with a database of more than a million other heart and lung scans from individuals in your comparable age and health range — and flags anything that might look like trouble.

If you get a clean bill of health, you can walk away knowing that your insides look good. If there is something wrong, however, the anomaly detection program will be able to spot it before it becomes a problem.

In the old days of 20th century medicine (what we’re living now), your doctor basically had to guess at whether your insides were healthy or not, using a very limited set of clues. When scanning and imaging technology advances far enough, however — a process on its way as we speak — most types of problem will become spottable very early on, in exacting, micro-level detail, by way of a quick, low-cost medical check-up.

Emerging From the Dark Ages

If you think that sounds good, just picture this. On the same visit, the medical tech takes a drop of blood from your finger and runs it through another very powerful analysis machine. What this machine does is detect “cancer proteins.” It can tell you, through a quick and painless blood scan, whether you have cancer present or not — and where in your body it is likely to be located.

From what medical science now understands, the majority of cancers that form in the human body emit a certain type of signature protein that is detectable in the bloodstream. This makes early cancer detection a matter of 1) identifying all the relevant proteins, 2) creating a massive database of those proteins, sort of like a fingerprint database for disease, and 3) perfecting the detection technology for mass-market deployment, so that the blood reader machines become cheap and efficient enough to work in a clinic-type setting.

Getting the technology right, and sorting out all the various biological elements, is a huge nut to crack. But when the medical scientists who have been working on this thing for years do crack the nut — and in time they truly could — it may then become possible to detect cancer tumors while they are still tiny… and to do so via low-cost medical check-up procedures like the one just described.

Right now we are still in the dark ages when it comes to cancer. There are no early detection methods that make sense. Visual inspections of X-rays and the like are hardly any good, because too many “soft tissue” type cancers are almost impossible to spot before the tumor grows to a certain size.

Of course, by the time a tumor has gotten big enough for a doctor to see it, it may well have also grown big enough to be life-threatening. Fast, cheap, protein-based detection — at the stage when the offending tumor is still a tiny ball of cells — could thus change everything.

A Major Sea Change

Thanks to advances in modern medical technology, it really is possible that the Big Three — heart attack, cancer and stroke — could one day become anecdotes of the past, or at least fall way, way down on the cause of death league tables.

Again, think of the car analogy. The reason we don’t see cars breaking down on the side of the road all the time is because of early detection and preventative maintenance. Most people understand that you have to check the oil every 3,000 miles… that you need to make sure the fluids aren’t low and take the car in for tune-ups, and so on.

The entire medical system as it exists now, in contrast, is not aimed at early detection or preventative maintenance. The only early detection measures taken are superficial ones at best, simply because this is all that modern technology allows for given constraints of time and cost. (Why do doctors look for colon cancer and breast cancer and skin cancer in routine checkups, for example, but not other types of cancer? Because those three types of cancer are in areas where the doc can actually look!)

As it stands now, the vintage 20th century medicine-industrial complex is geared towards emergency repairs of the human body after it breaks down. Meanwhile, big pharma companies are in the business of pumping the human body full of highly expensive drugs as it is in the process of breaking down — with a lucrative sideline of providing “better safe than sorry” drugs to millions who don’t need them.

So when we really get this early detection thing right — when we have the ability to walk into a clinic and get a clean bill of health from a 3-D imaging analysis and a “bleed to read” cancer protein spotter on a chip — the entire field of medicine will change. Problems will be spotted and taken care of long before they become life threatening. Needless drug regimes will be eliminated (or at least drastically reduced). With a dramatic shift towards technology-enabled low-cost problem detection, the number of “Big Three” terminal cases will fall sharply as problems are pinpointed and caught early. And society will benefit greatly from it.

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Originally published August 18, 2009.

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