The Speculist: A Better Illness

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A Better Illness

On Sunday I told the FastForward Radio audience that I had a cold. I was sure I was going to go into a coughing fit during the show. The show went fine but this cold got worse over the next couple of days. Today's Wednesday and I'm thankful to be feeling better, but the last couple of days have been miserable. It's the sort of thing we all get to go through about once a year. The runny nose, the cough... the works.

My doctor assured me that what I have is almost certainly viral. Antibiotics won't help. "Don't go to work," he said. "Go home, take it easy, drink plenty of fluids and get rest." How old fashioned is that advice? I'll bet my grandparents got the same advice 50 years ago.

So, with time on my hands the last couple of days, I got to daydreaming about what kind of care would be ideal for these minor - or not so minor - colds and flus. When we understand how to combat these illnesses, how would the treatment work?


Sunday Morning, November 20, 2016

I awaken with the realization that the illness I've been fighting has gained the upper hand. My throat is sore and I've got the beginning of a runny nose. No problem. After a light breakfast I call my doctor's office.

Of course the doctor himself is not in on Sunday morning, but it hardly matters. The call is forwarded to the local hospital's 24/7 clinic. The attending doctor writes down my name and symptoms and asks that I come in as soon as possible. "Can you get here this morning?"

"Yes, I'll be right there." I make myself as presentable as possible and drive down to the hospital.

Once I arrive I'm taken quickly to an examination room. Doctors have decided that packed waiting rooms full of sick people is bad practice. If there's not an exam room available, patients are encouraged to sit in their cars and wait for the call to walk in.

In the exam room the nurse asks me my symptoms again. She writes it up on her medical PDA. She then takes a swab culture from the back of my throat. She takes the culture down the hall to a flash sequencer. This DNA machine doesn't require that the culture be grown any larger. The little swab in the bottom of the Petri dish is sufficient. The machine is a powerful AI that knows more medicine than most doctors. But it is not considered self-aware.

The machine dutifully goes to work. It has received the symptom reports from both the attending doctor and the nurse. It already expects what it will find, but it goes through a full screening. First, it detects my own DNA. After a brief search for genetic abnormalities it continues. It detects the DNA of several bacterial species - two of which are beneficial for healthy oral hygiene, one of which is unhealthy and is responsible for tooth decay. The machine makes a note of that, but keeps looking. Then it finds what it's looking for. A viral infection - Strep type 10237a. It goes to the online database to determine how widespread this virus is.

Since the virus is already common in this region, and easily treated, the machine will not recommend quarantine. It reports this new case for the database and backs out of the network. It completes its search by looking for markers for cancer. There are none.

The machine produces a report for the doctor. It recommends prescriptions for two drugs - an anti-viral medication developed specifically for this virus, and a mouthwash to fight the harmful oral bacteria. The mouthwash is not an antiseptic. It is an active culture of beneficial bacteria - reinforcements for the good guys.

A doctor gets this report on his prescription pad PDA. He signs it almost perfunctorily and walks in to see me. He tells me what they found and asks me which pharmacy to send the prescription to. He forwards it electronically. My pharmacy's AI will call as soon as the prescription is ready.

I know that the pharmacy is fast so I don't go back home. Thirty minutes later I'm leaving the pharmacy with my prescriptions. The doctor has encouraged me to begin taking the medicine immediately. I do. The doctor tells me to expect feeling better by the evening. He's right.

By Monday morning I feel 100%.

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