By Mary Kozelka
Rock Center

It happened on flight from Washington, DC to San Diego.

The pilot’s urgent question reverberated over the intercom during a cross country flight, “Is there a doctor on board?” A passenger was experiencing severe chest pains, and luckily for him Dr. Eric Topol was sitting in seat 6A.

Topol is the energetic chief academic officer of Scripps Health, a prominent cardiologist and the foremost figure in the field of wireless medicine. He believes the future of health lies in our own hands, namely in our smart phones and other portable electronic devices.  According to Topol, “the smart phone will be the hub of the future of medicine.  And it will be your health-medical dashboard.”

That day on the airplane, Dr. Topol displayed the potential of wireless medicine when he snapped an AliveCor device onto his iPhone and performed a cardiogram at 30,000 feet. Using this portable, cellphone powered device, Topol was able to see that the passenger was definitely having a heart attack and he recommended an urgent landing. The passenger was rushed to the hospital and survived.

Topol said this was a “Eureka!” moment for him; such devices could lead to better and cheaper health care everywhere, from airplanes to senior citizen’s homes.

“These days, I’m prescribing a lot more apps than I am medications,” he continued.

Topol points to a growing number of apps and devices, none of which he is paid for using or endorsing, that are capable of measuring vital signs and then transmitting that data to smartphones. Whether it’s your blood sugar levels, your heart rate or your sleep habits, Topol believes we should track our own conditions through our phones and use that data to see patterns and warning signs of illness.

Topol speaks of a not-so-distant future where human beings are digitized through sensors in the bloodstream. He explains, “By having a sensor in the blood, we can pick up all sorts of things, whether it’s cells coming off an artery lining [indicating heart attack], whether it’s the first cancer cell getting in the bloodstream, whether it’s the immune system revving up for asthma or diabetes or you name it.  All these things, will be detected by sensors in the blood which will then talk to the phone.”

And when one of these warning signs is picked up by the sensor, a special ring will be sent to your cell phone. Like an engine warning light on your car’s dashboard, this ring will indicate that trouble is brewing in a certain area of the body. Ideally, this would prevent life threatening incidents, like heart attack.

Topol calls the medical community ossified for its hesitance to embrace wireless technology. This he sees as destructive to the advancement of medicine.

He is similarly critical what he calls “population medicine”, in other words, one standard method of treatment used on all patients.  He says that mandated mass screenings, such as the annual mammogram for women over 50, are not only wasteful, but can cause needless anxiety from false positives and biopsies.  Only 12% of women will ever get breast cancer, so instructing that all women be screened yearly exposes many to unnecessary radiation and often leads to false positives and biopsies causing needless anxiety for both the patient and his or her family.

When describing medicine today, Topol says most doctors “fire into a black box, give someone medication, go home and pray.”  He argues that instead, in the near future, everyone should have his or her DNA sequenced which would reveal what diseases or conditions an individual is prone to, and also what types of drugs will or will not be effective for that particular individual.  Topol is in full support of DNA sequencing, but there is some controversy regarding how effective DNA sequencing is when it comes to predicting illness.

Right now a full DNA sequencing costs about $2,500, but Topol expects that within the year, the cost will drop by more than half. It is his hope that DNA sequencing will soon be affordable for all.

Topol further predicts that finding a cure to ailments from cancer to heart disease depends on sharing our medical information. He insists that if we were serious about the war on cancer, every single person who had the disease would get his or her tumor genome sequenced, record treatment techniques and outcomes, and then make it all public knowledge.  This data combined has extraordinary potential.

His enthusiasm is infectious as he describes his vision for the near future, “If we started to bring all this information together, the acceleration of knowledge and the transformation of what we could do for the future of disease would be extraordinary.”

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For our current physicians and health care providers, the use of such digital devices is undergoing a period of integration and adoption. After all, the stethoscope has worked well for hundreds of years, why go digital if you don’t have to, right?

But there is a new generation of physicians being trained as we speak, and one school is leading the way and reinventing the way medicine is taught. UC Irvine School of Medicine’s iMedEd Initiative has recently been selected as an Apple Distinguished Program for its use of iPad technology that is integrated into their curriculum. Students literally have all of their textbooks, tools, and devices at their finger tips! Most notable about UCI’s program is the fact that participating students scored an average of 23% higher on their national exams than students not in the program but who entered with similar MCAT scores and GPAs.

From Janet Gehrmann ’12, our voracious article-reader:

http://www.npr.org/blogs/health/2013/01/04/168626218/grades-for-doctors-get-an-incomplete

http://www.nytimes.com/2013/01/09/business/health-care-and-pursuit-of-profit-make-a-poor-mix.html?_r=0

http://www.nytimes.com/2013/01/17/health/disgusting-maybe-but-treatment-works-study-finds.html?pagewanted=2&_r=0

A little light reading over break!

Professor Darla Thompson, Middlebury Dissertation Scholar in the American Studies department, is teaching a very interesting course this spring.  She’s holding it at night so science majors can take it.  Could make a great elective…

22434  AMST 0308 A   25  Race: Sci, Med. & Diversity  W  07:30 PM  10:25 PM  AXN 220  Thompson, D   25

AMST 0308 – Race: Sci, Med. & Diversity
The Power of Race: Science, Medicine, and Human Diversity

In this course, we will explore the manner in which ideologies of race have shaped the histories of science and medicine, and how scientists and medical practitioners have shaped the history of race. Topics will include the role of scientific knowledge in debates about racial slavery in the U.S., eugenics policies in the U.S. and Puerto Rico, tropical medicine in the Philippines, and public health policies in Los Angeles and San Francisco. We will pay particular attention to recent debates regarding the uses of race and genetic ancestry in biomedical research and practice, as well as genetic genealogy. 3 hrs. sem.

We have just received a good-sized list of websites having to do with research programs over the summer, from such institutions as the NIH, NSF, US Dept. of Health and Human Services, Howard Hughes Medical Research Institute, May Clinic, various universities and med schools.  Write Annie if you are interested in researching research opp’ys!

ATTENTION HEALTH-PROFESSIONS JUNIORS AND SENIORS:

Note that Mrs. Wickland will hold a meeting for you on Tuesday, October 2, at 6:30 p.m. in Bi Hall 104:

If you’re going through the committee this year and applying for matriculation in medical, dental, or veterinary school—or if you’re a senior and going to do this after a gap year or two (but you’re here now, and can take advantage of that!)— come to the meeting to learn about the Committee Process.  Get started on the right foot . . . in a timely manner!

Information received lately over the e-mail from various counselors:

The American Medical Student Association has an International Health Opportunities database where premeds, among others, can explore different types of health care opportunities being offered by organizations in countries throughout the world:

http://www.amsa.org/AMSA/Homepage/EducationCareerDevelopment/IntlHealthOpps.aspx 

* * * * *

There are many non-profits that offer overseas volunteer health care-related opportunities.  They’re generally expensive; many  offer suggestions for fund-raising.  

US medical schools value commitment to a human service project (health-related or other) over a period of time. What counts is what the student learns about him/herself.  Some overseas projects offer variable time commitments, but most students go for only short-term stays.  It’s a good idea for premeds to look in their own backyards first-  benefits include lower cost, easier long-term involvement, and most important of all an opportunity to learn some important things about issues in U.S. health care for ‘neighbors’ whose lives were invisible to them previously.  Local Area Health Education Center (AHEC) offices have clinic listings across the country.

But-  If you can afford it and work abroad is a high priority for you, Child Family Health International has a good reputation  http://www.cfhi.org/  

Also see list of Other International Opportunities on http://fmignet.aafp.org/online/fmig/index/getinvolved/int.html  

We just received a flyer on a resource available at

www.ExploreHealthCareers.org

which gives information on over 120 health careers, with overviews vetted by accrediting bodies and national associations.

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Their self-description:

Beginning in the fall semester of 2012, BIOL 0140 will be open only to students who have earned fewer than 21 credits at the time of registration (i.e., first-semester first year students through first-semester juniors).  (As with the rest of registration, counts of credits do not include AP or IB credits; instructions for checking credit status can be found here: http://www.middlebury.edu/offices/academic/records/registration/classcalc.)   Students with 21 or more credits earned or in progress at the time of registration will be allowed to take the course in the fall only if spots are available after the first-year students have registered in the fall.  BIOL 0140 will remain open to all students, regardless of credits earned, in the spring semester.

ENVS students hoping to take BIOL 0140 as a science cognate, and pre-med students hoping to take BIOL 0140 to fulfill their biology requirement for medical school should plan accordingly.

Please direct any questions to Andi Lloyd, Chair of the Biology Department.

Partners In Health produces and contributes to numerous publications intended for a wide variety of audiences and purposes.

We publish a monthly electronic news bulletin and annual reports aimed at informing friends and supporters about our work.

We contribute articles to scientific and scholarly journals, reporting on research and analysis intended to improve treatment outcomes for patients and strengthen understanding and implementation of our model of community-based care.

We prepare and publish manuals detailing both our community-based approach and clinical protocols for use by healthcare practitioners working in resource-poor settings.

We write and edit books that present the lessons we have learned and the perspective we have gained over more than 20 years of working for quality health care and social justice in poor communities on four continents.

And we advocate for the rights, needs and priorities of the poor and the sick in essays, speeches and articles for newspapers and magazines intended to reach a wider audience of concerned citizens, policymakers and activists.

Publications sorted by country and topic

In order to make it easier to find and access publications of interest, we have cross-referenced them both by the countries and the issues to which they refer. To access publications of interest, select a country or topic from the table below.

Go to http://www.pih.org/pages/pih-e-bulletin-2011-03 for current and important articles on fighting chronic diseases, training for health, report from Rwanda, a North Carolina high school’s involvement in social justice and global health, and tuberculosis.