The Second Life Hospital.

'The Web will provide a panalopy of virtual environments to explore. We will visit these places and have any kind of interaction with other people, ranging from business negotiations to sensual encounters...Virtual reality environment designer will be a new kob description'-Ray Kurzweil.

Let's assume that this description actually reflects the Internet of the future. If so, it could be that Second Life is a kind of fore-runner of the next-gen Net, in the same way that today's World Wide Web grew out of Arpanet. In that case, it would be prudent to consider how the levels of interaction and communication provided by Second Life today could affect our lives in the future. For instance, what if healthcare were provided for in Second Life?

To answer this question, we first have to consider what disadvantages hospitals and doctor's surgeries have. They are highly centralized institutions built on the scarce resources of buildings and skilled professionals. A Second Life hospital would be highly decentralized, capitalising on the ability to work along with people who are geographically remote, the ability to quickly share information and the amplification of skills. Anyone, regardless of where they live in the world, could potentially have access to the best medical advice, and it might even be possible to perform surgery via remote-control robotics.

It would be rather optimistic to say that a fully-functioning hospital could be built in SL right now. But I want to argue that there exists a range of tools that, with further refinement, could bring this vision to life. We should also recognise that the Internet is not robust enough in its current form for this purpose. I don't want to talk about the kind of Net we would need, but if you are interested in this area, Wired.com has an excellent article called 'Only Connect'.

The Second Life hospital requires tools that enable a doctor or team of surgeons (who may be geographically remote) to examine a patient. With teams potentially far apart in a physical sense, tools that allow diagnoses to be quickly shared in VR would be invaluable. Finally, and most importantly, we need ways to fix patients without them necessarily going to any fixed location.

Let's start with tools to remotely examine a patient. A pair of newly patented technologies could allow for cameras that take higher-quality pictures than those offered by the current top-of-the-range. They would also run for years on a single charge and are the size of a shirt button. Such a camera could be swallowed, and upload pictures to the Sl server via a wireless link. Another camera called the M2a gut-cam, can already be swallowed like a pill and I recently saw a program where a woman did just that and you could log onto a website and watch its journey through her digestive tract.

Another example of remote viewing is a microscopic vessel developed by a team at the University of California. It can be remotely piloted through the esophagus, stomach,small intestine and colon to find tiny tumors.

These tools would allow the remote examination of the digestive system, but what about the other organs? The University of Turin has devised the Trim-Prob (Tissue Resonance Interferometer Probe) that can be waved over the body like a wand and detect tumors with a degree of accuracy approaching CT scans and MRI images. It costs 1% of the price of an MRI scanner and could one day be developed into a Star-Trek style wand that you wave over the body.

A more long-term goal would be the bio-degradable and biocompatible nanoprobe, a device that would provide high-resolution scans from inside a person's body. The basis for this technology are conducting polymer nanowires that are so miniscule they can easily be threaded through the tiniest caplilliary. By gaining access to, and providing information on our organs on the scale of individual cells, this could lead to highly detailed scans of the human body.

Potentially, a patient could be scanned, and an avatar could be created that is an exact copy of the biological original-a kind of 3D version of the images we capture today with MRI. We are already down the path of modelling the workings of the body in software. For instance, the Cardiome Project seeks to accurately simulate the cardiovascular system, from single cells up to the entire heart. DARPA are intent on simulating every aspect of the human body, incorporating all genetic an proteomic information on a molecular level. I would tentatively argue that we may one day possess the ability to scan a patient, and build a bio-identical avatar that acurately models the workings (and malfunctions!) of that individual.

Could we even capture any bacterial and viral afflictions? Let's assume not, in which case the Second Life doctor would need a way to remotely diagnose a condition. There exists today tools that enable diaognoses to be carried out while physically remote. Microchip-based protein and gene analysis systems allow thousands of tests to be rapidly administered at home. There is a tiny handheld device with DNA sensors on a microchip that can detect diseases using a drop of saliva. 'Nanozoomer' is a system that turns a glass-slide into an electronic image that could be sent to specialists all over the world. The glass slides are scanned at high-speed as they pass through the system, so any PC can be used to zoom in for higher-magnification examination. Replacing glass slides with a digital file allows for easier storage, and easier sharing and simultaneous viewing at multiple locations.

Burstein technologies have made a device that allows patients to put biological samples into a specially designed CD-ROM disk and insert it into a CD/DVD player attached to an ordinary PC. The disk drive acts as a centrifuge, prepares the sample; a laser reads it, translating the chemical or biological data into computer code. The software analyses it and transmits it to a physician via the Internet.

With these technologies, you could enter Sl, go to the in-world doctor, and have your condition diagnosed online. The doctor could consult and share data with experts in close proximity in VR, even if they are separated geographically. Once a treatment is decided upon, the drugs could be delivered to your home.

But what if you required surgery, rather than a course of drugs? How can surgery be performed in VR? Remote-control robotics would be the answer. In 2001, doctors in New York used a remote control robot to remove a gall-bladder from a woman in France. Earlier I mentioned a microscopic robot that looks for tumors. The designers are working on a future model that can be directed to destroy any tumors it finds. Ultimately, we will have billions of nanobots that could be injected or swallowed. The surgeon could be in a VR environment where things are scaled up massively, kind of like that Burning Life sculpture of a gigantic human heart. As the surgeon works on the massive VR bone-fracture or whatever, his or her movements could be translated into very delicate operations conducted by the nanobots, achieving a degree of control far in excess of crude human fingers.

With this level of technology, you would no longer need to fly to France to see that world-class brain surgeon. You could go to Second Life and the surgeon could operate on you using a combination of remote sensing, bio-identical scanning/modelling and nanorobotics. Surgery from the sofa! Since this is VR, we could also tailor the hospital to suit personal tastes. A child, for instance, could be diagnosed by a doctor whose avatar is his or her favourite teddy bear, whose surgery looks exactly like the fairy tale castle of a treasured story.

So far I have shown ways in which we can decentralize the physical institutions of hospitals etc. But I have said nothing about how we can replicate the skills of the surgeons themselves. This is a task for artificial intelligence, another path we are already journeying down. Abbot Laboratories claims that six human researchers in one of its labs equipped with AI-based robotic and data-analysis systems are able to match the results of 200 scientists in its older drug-development labs. Petri-co is developing an AI-based test looking for unique patterns found only in the presence of cancer. In an evaluation involving hundreds of blood samples, the test was 'an astonishing 100% accurate in detecting cancer, even at the earliest stages'.

Pap-smear slides in the USA are analyzed by a self-learning AI program called focal-point. It is a system that can learn by watching expert pathologists. 'That's the advantage of an expert system. It allows you to replicate your very best people', commented Bob Schmidt.

AI has something of a bad reputation as an experiment that failed long ago, an attitude that does not take into account the huge number of narrow-AI applications that run many facets of our civilization, as well as the progress that is continually made in brain-reverse engineering and modelling. But if we tentatively assume we can produce software that models the knowledge and skill of a human surgeon, we could combine this with the advantages inherent in our technology. Machines can quickly share their knowlege. If a surgeon is busy and there are ten patients waiting to be operated on, no problem. Just copy and download the software into ten sets of nanorobots. Machines can remember billions of facts, no more waiting for the doctor to look up your personal file to chart your medical history. Robotic surgeons could work 24/7 and not feel the affects of tiredness.

Right, so let's put all this together and imagine a visit to the Second Life Hospital. Being a sci-fi fan, I request that the hospital has a futuristic flavour, and am delighted to find myself aboard the Star Ship Enterprise. The doctor calls me in and, oh lucky me, he looks just like Johnny Depp! After an all to-brief hands-on examination, Dr Depp has diagnosed the problem. It looks like I need surgery. The nanobots are delivered to my home, which I inject into my system and log into Sl once more. As I lay on my sofa, wearable wireless computing systems and retinal scans provide full-immersion auditory and visual VR. I am not in a operating theatre, I lay on a beach with Nurse Angelina Jolie holding my hand. As the surgeons operate on my avatar, the nanobots operate painlessly on my body.

Well, it's a dream, but one that is built upon tools that exist in a primative sense today. We obviously can't build a fully working hospital in Second Life right now, but if we call this step D (totally arbitary number) we could perhaps visualise how to get there from step C, which we reach from step B, that was reached from step A and can be implimented in Second Life right now. How can healthcare be combined with Second Life right now for mutual benefit? This is a question I will cover in a future thread and, as ever, anyone wishing to discuss this is welcome to contact me in-world.

This post violates the the longer then my arm rule.

May I have a cliff notes version?

It also violated my length of hand rule.

This post is really in need of explanatory pictures.

Okay, I usually never do this, but I read it! (regrets doing this and will never do it again)

In summary, Extropia is suggesting that there be RL medical treatment access through SL through various technology tools that are available irl and integrate them into sl. Everything from getting medical advice to actually receiving treatment.

My response to this, is although this is quite interesting entertaining the thought, the chance of SL ever getting to that point is very slim and definitely nowhere in the near future. They can't even get features implented into SL that they have been promising for 2 years now.

MJ

SL's code, three years into the process, can't even reliably display avatars. The "Other People's Avatars Invisible Only Their Attachments Show" still strikes on a regular basis.

Extropia's post is nice and thoughtful and science-fiction-y, but I don't think SL is a likely platform for anything mission critical.

On the first point, just change your group. Works like a charm. Though, yes it remains an annoying little bit of SLery (feel free to pronounce that as celery ).

On the second, MY amusement IS mission critical, dammit.

I need an SL-type Operation game where the Doc tinkers around with my AV and simultaneously, robotic arms poke and prod me in my RL home. What could go wrong?

Doctor: Scalpel
Nurse: OK
Doctor: Suction
Nurse: OK
Doctor: Forceps


Doctor: Forceps!


Doctor: Damnit, we are going to loose him...FORCEPS!!!
Nurse: We are having another permissions bug...they are now no transfer.

beeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeep

Doctor: We lost another.

You forgot my morphine drip.

Ever played Theme Hospital? They had some cool diseases. Zombieism, etc. And the nurse on duty had a lovely way of dealing with patients... "No dying in the corridors!"

My savior!

This might be a giant surprise, but I was already aware of the change your group trick. It's insulting that you would suggest it me, and disappointing that you would say anything to even suggest that having a workaround for the programs flaws is as good as having the program work correctly.

Me changing my active group ten to twenty times a session (when the problem is acting up) is not the same as SL being competent to display avatars properly.

Acting as if using workarounds is the same as having properly functioning code is bad. Very bad.

I wouldn't want to have anything as incompetently written as SL working on my body.

Especially not if the programming staff thinks workarounds equals properly functioning code.

Lol. Yes, I would not recommend opening a fully-functioning hospital in SL right now. The responses I have recieved so far have had the classic flaw of most arguments against a radical future proposal: They portray the proposal as if it were being implimented using TODAY'S technology.

This is a proposal for the World Wide Web of 2040 and beyond. If you had wandered around the Xerox Palo Alto Research Centre in the 70s, and had stopped to consider the implications of all that strange talk about 'operating systems', 'laser printing', 'icons', 'graphical user interfaces', 'network protocols' and a nifty invention called a 'microprocessor', you might have entertained the notion 'world-wide-web' of computing systems. Then other people would tell you that would be nigh on impossible with 1970's technology.

Nonetheless, the enabling factors of the World Wide Web of the 90s were in place in the 70s. The enabling factors for decentralized, automated healthcare via the Internet of the 2040s exist, now, in the first decade of the 21st century.

I remember Theme Hospital. Particular fond memories of 'bloaty head disease', the cure of which was to have the unfortunate's head popped with a pin and reflated with a bicycle pump

I would find it rockin' to get tricked out in little space suits and go on some sort of Fantastic Voyage. You know, with a shrink ray, turn us all into microavs and fly into someone's ear. And then head to the heart of it all.

That being said, I applaud Extropia for such an extensive and well-written original post, well-tempered in its flavor and zest, brimming with humor yet coupled with visionary foresight.

After reading Extropia's bit about the pap smears...

When I was at Westpointe, I was thinking how wonderful it'd be to have more gynecology in SL. I'm not kidding, I have an uncle who's a (retired but nevertheless a) gyno and he's made some comments over the years that made me think about exploring those sorts of possibilities here. Remember those "arches" in Patch Adams, starring Robin Williams? Ha-ha!

"Oh crap, he's lagging! Get the cachecleaners!"
"Doctor, I think he's going to crash"
"f*ck!, give him a fort buff already!"
"We need to turn down his draw..... 'fort buff', do you even know what game we're playing here? This isn't 'World Of ER Surgery!"
"Shut up, I'm trying to cam in so I can get the clot in this guys brain and edit it out."
"Did the patient give you rights to edit his body before he passed out?"
"Oh... crap."
*beep, beep, beeeeeeee.........*
Patient Noobie has logged off, permanently.
"Do we pronounce time of llDeath by my clock or theirs?"

You repeatedly used SL thoughout your post, it's hardly surprising that people would think you were talking about SL of the future as opposed to a variety of companies offering virtual reality, telepresence, nanotechnology, etc.

If one wants to get real science-fictiony just have medical nanobots with molecular computers inside them, no need for all the stuff going on long distance that way. Or just rewrite our genetic code so we don't have medical problems and have immense regenerative powers to deal with accidents.

Wow!

I just thought I'd take the opportunity, since you mentioned it, to note a little trick other people might not already know. Of course it isn't sufficient, but it is what is available.

A thousand apologies

All thousand apologies gladly accepted.

Remote medical procedures is a bit of an interesting topic - I dont think SL itself will ever be at the level to do it (It's just not structured the right way), but that doesnt deny the technology as a whole - if bandwidth and low latency is vastly increased from today's levels, it might be possible.

But, SL has shown some promise in the field of psychiatric help - I've heard of a few cases where this has already been put into practice. (Wilde Cunningham[?] is one such example.)

IMGO, Wilde Cunningham wasn't so much "psychiatric help" as freer personal self-expression due to debilitating conditions; definitely therapeutic and healing tho. The Virtual Hallucinations build would be a longstanding demonstration to help others understand what schizophrenia is like, and Brigadoon is a place for people with Asperger's and forms of autism to ease into socialization with others.

I agree that it was not a good idea to make continuous reference to Second Life. However, my thread began with a quote of Ray Kurzweil's in which he portrays the Web of the future as being a bit like the Matrix, or the Metaverse of 'Snow Crash' fame. IF this forecaste is correct THEN Second Life could be seen as a precurssor to what the Internet of 20?? will be like. The term Second Life was used in reference to this future Web, in much the same way as discussions of the potenital of ARPANET would really have been about the Internet.

Oh, and here is an interesting proposal that is kinda relevant: www.accelerating.org/metaverse.html