The tech for surgeons to operate on patients from hundreds or even thousands of miles away has been possible for over a decade. But will it ever become commonplace? ... real benefits, though, are for the patient. Thin, dexterous tools are precise over a large range of motion. For example, Tewari used the forceps to tie a series of knots with thin string to suture up his incisions, which makes it easier for surgeons to spare healthy tissue when cutting out an unwanted mass. Tewari says that at his hospital, the use of robots has cut the recovery time for prostate surgery from four days to just one or two. No surprise, then, that robotic procedures are more popular than ever. In 2010, 86 percent of prostatectomies were done with robots, and they are used to operate on hearts, kidneys, gallbladders, and ovaries. In 2012, 450,000 operations were done with robots, according to the Wall Street Journal. ... Some optimistic experts says it's only a matter of time until researchers fix the technical challenges that prevent doctors from operating from another state or country. But from cyber security to connection speeds to legal gray areas, there are a host of potential problems with remote surgery. Under the wrong conditions or in the wrong hands, surgical tools can do more harm than good. ... researchers found that the surgeons didn't notice if the lag time was less than 250 milliseconds. Higher than that, though, and their performance suffered no matter their level of surgical experience
We have a certain heroic expectation of how medicine works. Following the Second World War, penicillin and then a raft of other antibiotics cured the scourge of bacterial diseases that it had been thought only God could touch. New vaccines routed polio, diphtheria, rubella, and measles. Surgeons opened the heart, transplanted organs, and removed once inoperable tumors. Heart attacks could be stopped; cancers could be cured. A single generation experienced a transformation in the treatment of human illness as no generation had before. It was like discovering that water could put out fire. We built our health-care system, accordingly, to deploy firefighters. Doctors became saviors. ... But the model wasn’t quite right. If an illness is a fire, many of them require months or years to extinguish, or can be reduced only to a low-level smolder. The treatments may have side effects and complications that require yet more attention. Chronic illness has become commonplace, and we have been poorly prepared to deal with it. Much of what ails us requires a more patient kind of skill. ... Observing the care, I began to grasp how the commitment to seeing people over time leads primary-care clinicians to take an approach to problem-solving that is very different from that of doctors, like me, who provide mainly episodic care.
Aching, throbbing, searing, excruciating – pain is difficult to describe and impossible to see. So how can doctors measure it? ... During that period of convalescence, as I watched her grimace and clench her teeth and let slip little cries of anguish until a long regimen of combined ibuprofen and codeine finally conquered the pain, several questions came into my head. Chief among them was: Can anyone in the medical profession talk about pain with any authority? From the family doctor to the surgeon, their remarks and suggestions seemed tentative, generalised, unknowing – and potentially dangerous: Was it right for the doctor to tell my wife that her level of pain didn’t sound like appendicitis when the doctor didn’t know whether she had a high or low pain threshold? Should he have advised her to stay in bed and risk her appendix exploding into peritonitis? How could surgeons predict that patients would feel only ‘discomfort’ after such an operation when she felt agony – an agony that was aggravated by fear that the operation had been a failure? ... There seemed to be a chasm of understanding in human discussions of pain. I wanted to find out how the medical profession apprehends pain – the language it uses for something that’s invisible to the naked eye, that can’t be measured except by asking for the sufferer’s subjective description, and that can be treated only by the use of opium derivatives that go back to the Middle Ages.