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What’s More Affordable Than Free?

Fri, 12/18/2009 - 5:13am
Hans Patrick Griesser

Hans Patrick Griesser’s story "WHAT'S MORE AFFORDABLE THAN FREE?” was a runner up in the MedGadget’s Medical Sci-Fi Writing Contest.

December 18, 2009

“No, Grandma. It's a reverse pinch.”

“What does that mean?” she asked.

“It's like you're spreading it out to zoom in.” Jonathon patiently tried to explain it again. His grandmother gripped the small phone with the big display trying to throttle it into doing her will. Her face showed combined expressions of frustration, confusion, and annoyance.

“Out to go in?” His grandmother exclaimed. “That makes no sense at all!”
Jonathan reached over to touch the phone display. “Watch, put your thumb and finger around the part that you want to see. If you move your fingers together, the picture gets smaller. Move your fingers apart, bigger.”

“I'll never remember that. How will I ever remember that?”

“It's intuitive, Grandma. It makes sense.”

His grandmother sighed.

Jonathon and his grandmother sat at the small kitchen table. Grandfather was looking drowsy in his big chair that filled much of their tiny apartment. Grandma, eyeing him, relaxed her death grip on the phone and set it next to the teacup.

“Things change too fast. My mother’s phone had a rotary dial. Your mother picked it up once and asked where the ‘talk’ button was. Now you just point to someone’s picture, it starts moving and you’re communicating.”
Jonathon exclaimed, “Grandma, telephoning is only a small part of what this does. Here, let’s register you on the OUCH site to see the surgery stuff.”

Jonathan took the phone. His fingers flew across the screen. “First we’ll enter your name… J..E..N..N..I...F…”

“Only one N, Jo-NA-thon,” she corrected him, emphasizing the middle of his name.

“Oh, right,” he mumbled, “we’ll quickly undo that.” With a quick, double-q shaped flick of his thumb and pinkie finger, Jonathon removed the extra letter.
“What kind of motion was that? My joints won’t move like that.”
Jonathan’s fingers danced more. “Okay, we’re in. You have an account.”

The screen filled with small images of anatomy, graphs, and lists. Jonathan navigated deftly through the images, first to a body then through the skin and into the abdomen. It was as if they were looking out the window of a little car driving through a multicolored canyon, but the rock features represented body organs.

“This is amazing. It blows my mind.” Grandma declared.
“Now look at this,” Jonathon said. “This shows where the gall bladder is, what it does, and how it's removed. Jonathon pointed to the picture on the screen. “First is a cut just below the rib cage. Then you cow-ter-ize it.” He stumbled on the unfamiliar word.

“Caught-you-eyes? What's that?”

“I’m not sure. But, Grandma, look at how I do this. It is so useful. If you don’t know what a word means, you touch that word and a definition appears in a bubble.”

“Well, how am I going to remember to do that?”

“Grandma, the more you do it, the easier it will be.” Jonathon continued, “Please. Look at this. The OUCH site has all this great information. It has everything you need to know.”

“Why do I need it when my grandson is here to help me?”

Grandpa’s eyes were completely closed. He grunted once.

This time, Jonathan sighed, “Grandma, I’m not here all of the time. You need to know how to do this. The OUCH site is run by volunteers, people in the same boat that we’re in. They don’t have money to see doctors, but information is free and easy to share. People post cures that worked for them and other people review those and vote on how well they work. This is where I got the recipe for chicken soup for my cold.”

“Chicken soup!” Grandma was getting excited again. “I would have made you chicken soup. Why are you getting a recipe? You don’t need a recipe. Eat a chicken, boil whatever is left in a pot, add vegetables, noodles if you have them, salt and pepper. There, you have soup.”

“Grandma, please. Let me show you more about the gall bladder operation.”

Jonathan pushed the phone closer to his grandmother. She adjusted her glasses so she could look down her nose at the images.

Jonathan continued, “See, it says here that to cauterize is to sear the edges of an incision to halt bleeding during an operation.”
“Sear, like with a branding iron?”

“I think the laser cutter does it. Look, this is the gall bladder. You can live without it. Once it’s removed, Grandpa’s pain should go away.”

“Oh, I don’t want to see this! It’s too graphic.”

“Grandma, you need to know what is going to be done. Look, after cutting it out, stitches go here, here, and here.” Jonathan scrolled through the images while his grandmother watched with fascinated revulsion.

Grandpa did not move through any of this discussion.

When video cameras and the internet allowed doctors to monitoring patients at home, it was a boon for hospitals because one doctor, anywhere in the world, could work with many patients. This quickly progressed to patients or their families performing treatments on themselves. The results were fewer visits to the hospitals, lower costs, better outcomes, a feeling of control for the patients.

Ironically, the boon resulted in fewer doctors because there was now less demand. The still overworked medical staff had even less time so, to get decent care, patients needed to know all about their conditions and available treatments. Websites were the obvious way to get information to patients. The government created some. Hospitals and insurers created more.

The most popular site was Open Universal Care at Home or OUCH. Like open source software, where computer code was freely shared, OUCH shared health care information. It marginalized the doctor. Members performed their own diagnosis, selected their own treatment, and monitored their own progress. The site was full of helpful advice ranging from Jonathon’s chicken soup recipe to encouragement about passing kidney stones. It had sections on herbal medicine, when leeches were helpful, what medical devices were actual useful, and recommendations for substitutes made with non-medical electronics. For instance, a downloaded music file and a good set of headphones can test your hearing ability.

The most versatile self-treatment tools were smartphones. First, they could access information from anywhere. Better, as more sensors and instruments were added to smartphones, they were used in increasingly varied ways. The accelerometer could measure the stability of your gait so software could predict the onset of neurological disease. The camera, held just right way, could check your retina for glaucoma. The trick was to sit in a dark room long enough to open your pupil very wide and let the shareware decide how healthy your eye is. Satellite based positioning receivers, temperature gauges, ultrasonic rangefinders, laser pointers, barometers, magnetic field strength sensors, and more were added to these “phones” over the years, and people found more and more things to do with them.

There was also a grey marketplace for accessories and drugs. Jonathan had diagnosed his Grandfather’s gall bladder problems with a blood analyzer attachment. He bought a power enhancement charger. He even acquired the anesthesia pills that were now putting his grandfather into a deep tranquil state.

Grandpa was breathing shallowly now. Jonathan and his grandmother looked at each other. “Okay, Grandma it’s time” Jonathon said as he plugged the power charger into his phone.

Grandma opened Grandpa’s shirt and pulled the lever to recline his chair. They had covered the chair with a tarp and old sheet before he sat down. He looked like a drunk lying in a snow bank, but Jonathan and Grandma gazed at him with love and worry. Grandma leaned over, kissed his forehead and stepped back. Jonathon swallowed hard and got closer.

Jonathan pointed the phone camera at his grandfather’s chest, close enough that the white curly hair showed on the phone screen. In the image, small squares formed around each nipple and the belly button indicating that the phone recognized those chest landmarks. A dotted line appeared, displayed just under the rib cage. The built-in laser pointer, which Jonathan usually used during sales presentation, turned on and swiveled to illuminate a line on Grandpa’s body corresponding to the dotted line on the display. This was where the first cut would be made.

“I don’t believe this,” Grandma whispered reaching for her sewing box.
“Here we go.” Jonathon pushed what was usually the volume button on his phone.

The laser grew brighter with a small whine. Smoke started rising from Grandpa’s abdomen along the illuminated line. The smell reminded Grandma of burning hair off a plucked chicken. She watched Jonathan and gripped her needle and thread, ready to sew everything back together.

With a small tremble in her voice, Grandma asked, “If we make a mistake, that phone can undo it, right Jonathon?”

Hans Patrick Griesser’s story "WHAT'S MORE AFFORDABLE THAN FREE?” was a runner up in the MedGadget’s Medical Sci-Fi Writing Contest.

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