At any other time and place, an injured knee would be no big deal. But weather expert Dar Gibson was working at the South Pole, in the middle of winter, when he fell and badly damaged a tendon in his left knee. None of Gibson’s 51 coworkers at the National Science Foundation research station were qualified to carry out the operation needed to repair the tendon, and the station’s clinic was not equipped for surgery. The extreme cold and total darkness of Antarctica in July meant that flying him out─or flying a surgeon in─was out of the question.
The station doctor told Gibson the bad news: without surgery, he would never walk properly again. A solution to Gibson’s dilemma arrived, however, in the form of the latest medical technology. A combination of computers and an advanced communication network allowed two physicians to help repair Gibson’s knee from their office in Boston, Massachusetts, many thousands of kilometers away.
The physician at the South Pole research station, Dr. Timothy Pollard, prepared Gibson for the procedure. Then he and a computer network specialist slipped on operating smocks and masks and turned to face the cameras that were beaming the scene to an office in Boston, where a surgeon and an anesthesiologist watched closely. An anesthesiologist is a doctor who is trained to administer the drugs that put a patient to sleep and who carefully monitors the patient during surgery. Using the high-speed connection, the Boston doctors examined x-rays of Gibson’s knee. Under their expert guidance, Dr. Pollard cut into Gibson’s knee, sutured the damaged tendon, and closed the incision. The two-hour operation was a success, and it is an example of a new trend in medical care known as telemedicine.
Telemedicine is, however, more than just talking someone through an operation. In 2001, a pair of doctors operated on a woman in France─while they were in New York City! The pair, one Canadian and one of French origin, didn’t just tell another doctor what to do. They actually performed the operation, removing the patient’s gallbladder by remote control. They used a computerized control panel and a giant television screen, as well as robotic arms located in the operating room in Strasbourg, France. The communications link was a private, high-speed line, which is far more reliable than an ordinary Internet connection.
The transatlantic operation, which was called "Operation Lindberg" after Charles Lindberg, the pilot who flew the first transatlantic flight, still needed the assistance of a doctor in France. He made four razor-thin cuts in the patient’s stomach and inflated it with carbon dioxide to give the robotic hands room to operate. The surgery itself, however, was performed by the doctors in New York. Each time they moved one of the instruments in their hands, the robot in France made an identical move about a fifth of a second later. Within an hour, they were done.
Operation Lindberg was an experiment, and the procedure cost thousands of dollars more than a normal operation. But many doctors expect that one day such procedures will become routine. Already, the U.S. government has approved a computerized, robotic surgical system, called da Vinci, for use in hospitals. The da Vinci system allows a doctor to operate on a patient’s internal organs without opening up the entire chest─the cuts have to be large enough only for a minuscule camera and tools, which are much smaller than a pair of human hands. This reduces the stress on the patient, speeds healing, and reduces the chance of infection. The surgeon watches a screen that shows inside the patient on a computer and manipulates hand-sized controls that direct the microsurgery instruments.
The da Vinci system was designed for operations in which the patient and medical team are in the same room. There is no reason, however, why the patient and doctor couldn’t be separated by an entire continent or ocean. The patient could even be on a space station.
The most common use of telemedicine, and the reason it was developed, is for medical care in remote locations, like the Arctic tundra of Alaska or the Andes Mountains of Chile. Governments cannot always afford to give every community the latest medical equipment, but sometimes they can find the funds for communications technology, which can be used for long-distance education and official state business as well as telemedicine. Computers are much less expensive than airplane flights, and for patients suffering severe injuries, evacuation by airplane is not always a good idea. In countries like Canada and Australia, where great distances separate population centers and hospitals and where clinics in remote areas have difficulty attracting qualified medical specialists, telemedicine is now well established.
In some cases, all that is needed for telemedicine is a good cell phone camera to transmit images of a patient’s injuries to an office, clinic, or hospital, either nearby or across the country. If the images are of high enough quality, a specialist may be able to prescribe a short-term treatment while the patient waits for the next chance to visit a doctor, or for the doctor to visit the patient. Furthermore, camera phones are getting better and better each year. Often, a trained nurse and someone who knows how to handle the communications gear are all that is required to bring faraway expertise to where it is needed.
Telemedicine is not just changing the way patients are treated. It is also changing the way doctors work. With a high-speed Internet connection and a state-of-the-art computer, it is now possible for radiologists─physicians who specialize in reading x-ray images, CAT scans, and MRI photographs─to work from home or even from a hotel room. Other doctors, meanwhile, frequently use videoconferencing equipment to consult one another. School nurses, battlefield medics, and family doctors in country clinics can use satellite telephones to talk with their colleagues in metropolitan areas, all thanks to the latest technology.
Not long ago, many people suffering from serious illnesses and injuries could only dream of receiving the highest quality medical care in their hometowns, or even in the comfort of their own homes. Yet that’s what telemedicine is offering─the return of the old-fashioned house call. The only difference is, with telemedicine, the visit is virtual.