Wednesday, November 24, 2010

Star Trek Medicine vs measuring health

The main medical item seen on various Star Trek shows (and various incarnations) is the medical tricorder.  Star Trek uses many types of tricorders, or scanners used for various purposes.  The medical tricorder is used to scan humans, animals and occasionally aliens for signs of illness.

Even in the Star Trek future, there seems to be no tool to measure 'health', only a tool to measure illness.  This is demonstrated fully in Star Trek Minutiae episode 131 (not Star Trek)\ where the doctor says:

"I’m not picking up anything on my tricorder scan. He seems perfectly healthy."

Apparently, if you are healthy, the tricorder does not give a reading.  The quote from Beverly in STTNG First Contact: "It's a... new medical scanner. It's a little more precise than an X-ray machine."  The medical tricorder is a diagnostic device - not a health measurement device, nor a treatment device.

The most talked about medical scanner in today's technology is the MRI scan.  Does the MRI scan reveal anything about your health?  No. The MRI scan searches for 'abnormalities' - on the assumption that if there are no significant abnormalities detected - you are healthy.   Health is not measured.

I wish for a future where we can measure health, instead of waiting for illness to 'strike' and then attempting to diagnose the illness.

What would our medical systems be like, if we could measure health?

How would 'clinical trials' be conducted if we could measure health effectively?  

We should measure the health of all subjects before the clinical trial.  Then apply the treatment.  And after the trial - or even during the progress of the trial, measure the subjects' health again.  'Side effects' are a measure of illnesses caused by the treatment.  We should also measure the 'health effects' -positive, or negative.

What would our 'health systems' be like if we could measure health?  I think it will take a very long time to answer that question.  When we can measure health effectively, we will learn many new facts, come to many new understandings.  We will learn that specific actions that improve health in the short term - might be detrimental to health in the long term.  Or that some actions that improve long term health actually harm short term health.  This does not surprise us - but it would be very useful to have a measuring tool.

A specific exercise, running five miles, for example, might be shown to harm immediate health status, to improve medium term health status and slightly effect long term health status.  We don't know.

Of course it's not that simple.  Even with a toolbox that effectively measures health - it still takes 10 years to measure the effects of a ten year change in health activities. And a lifetime to measure the lifetime effect of lifestyle changes.  This is the major reason these changes are personal - each person has a right to make their own decisions about health actions because the truth will not be known until they are dead and gone.

I firmly believe that measuring health is a serious deficiency in our current health systems and practices.

What might we learn about cancer patients, for example, if we try to measure health?  I often hear or read quotes like 'a cure for cancer', 'he beat cancer, but it struck again', and 'she was in perfect health, but suddenly struck by cancer'.  Does cancer strike suddenly?  We know it does not.  It takes years for cancer to grow to a dangerous level.  Many, if not most people over a certain age, have some cancerous cells - and their healthy body is dealing with them effectively.  But some people have either a more serious 'cancer', or a body in 'poor health', that creates a medical emergency.  If we could measure the 'health' of all cancer patients - we might learn more than any 'cancer treatment clinical trials'.

We might also learn that cancer is not just a 'cellular' disease.  Cancer cells exist, but the critical issue in a specific cancer might be nutrient health, tissue health, or system health or a combination of health factors.

We will be better equipped to find the 'cause' of many illnesses, if we can measure health effectively.  There are many illnesses, like cancer, multiple sclerosis, arthritis, etc where the cause is not clearly known.  Our current medical system searches for 'a cure', perhaps because once an illness is detected - finding a cure is more important than finding the cause. What if we could find the cause?  In some illnesses, like arthritis, we know there are many potential causes - and each individual suffering from arthritis may be suffering from several causes.  But current treatments for arthritis, generally, - ignore the cause.

We will be closer to finding and understanding causes when we start to measure health on all seven dimensions: nutritional health, cellular health, tissue health, organ health, system health, body health, mind health, spiritual health and community health.

When a doctor says 'he has the heart of a 20 year old', what does it mean?  Does it mean anything useful, anything accurate?  When we start to measure organ health and organize and analyze these measurements by demographics, we will be able to see that he really has the heart of a 24 year old, or not. We will also be able to tell if specific groups of people have better nutrient health, cellular health, etc - not just 'they live longer, but we don't understand why' or 'they are less likely to get heart attacks, but more likely to get cancer'.

Our medical system often speaks of the 'gold standard' treatment for an illness.  What is the 'gold standard' for measuring nutrient health?  What is the 'gold standard' for measuring cellular health?  What are the gold standards for measuring tissue health, organ health, mind health, spiritual and community health?

The sad truth is that we do not have any standards for measuring health.  And few tools. We have many tools that measure illness - few, if any, that measure health.

I believe in personal health freedom. An important step to achieving personal health freedom is the development of a suite of tools to measure health.  If you know of tools that 'measure health', as opposed to measuring illness - please leave a comment, or drop me a note.   

Tracy is the author of two book about healthicine: