I had the pleasure of attending a 100th birthday party last weekend. Can you imagine? Alive for most of the entire 20th century! She’s witnessed the discovery and invention of Insulin, hearing aids, helicopters, television, Tupperware, stereos, ballpoint pens, clock radios, credit cards, the polio vaccine, cellphones and the Internet!
My own life of more than half a century has witnessed the amazing way technology has enriched the medical field. When I was studying for my Master’s degree in 1993, I took a course called Technology Assessment. We studied the relevance, cost, risk, benefit and social and ethical implications of machines we use in Intensive Care. “Technology assessment” became personally relevant when I had a patient that was very sick. And I mean minute to minute kind of sick. We needed two nurses in the room the whole shift to care for this one patient.
I thought to myself “All of his vital organs are out of his body, except for his brain.”
• He had a ventricular assist device; a machine that takes over the work of the heart (and back then it was the only thing to buy time until a heart transplant)
• He had a ventilator to do the work of breathing for the lungs
• He had a continuous dialysis machine for kidneys that ran 24 hours a day and had to be “balanced” every hour with the amount of fluid going in against the amount of fluid going out
• He had about 10 different IV solutions hanging on poles
• He had a warming blanket to keep his body temperature normal since his circulation was flowing through tubes to a machine outside of his body
Heart, lungs, and kidneys all as machines, beeping and chugging and alarming and in almost constant need of attention. Except for his brain, his vital organs were assembled around his bed, instead of his family!
Did he really sign up for this? Could his family have imagined what they would be walking into when they saw him for the first time? These treatments are common today in ICUs all over the country. We can support someone with machines for a long time if it is necessary. Technology keeps expanding each year; as do the medical machines.
When things are moving very fast and organs are shutting down one system at a time, it’s challenging for a patient and family to weigh in with a “technology assessment”. It’s up to you to decide, to choose, to feel comfortable with your decision based on the resources available. But you have to know about these things before you’re under our care.
“Technology is a useful servant but a dangerous master.”
-Christian Lous Lange