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The Future of Healthcare

This is fascinating…

And General Electric (G.E.) comes through again with breaking technology

Healthcare

>>> story here tonight, we’re about to hear one of the smartphone may change his profession and personal medical his story tonight from dr. nancy snyderman.

>> why do we have people being treated like cattle herds? that’s waste. and the billions of dollars that’s being wasted each year for screening and the wrong drugs and the wrong everything. it’s astounding, and we just can’t go on like this.

>> i’ll take that, thanks.

>> reporter: dr. eric topol has long been one of the world’s foremost cardiologists. he has now become the foremost expert in the exploding field of wireless medicine. and this explosion, he says, is about to make our health care better and cheaper. watch what he does with his cell phone.

>> we’ll just pop this is phone into it like that.

>> reporter: he shows how simply his modified iphone produces a cardiogram for a patient.

>> so you just put your fingers on it. there you go. and in a second — you know, in the first or second it stabilizes.

>> reporter: the device was approved by the fda in december and is now sold to physicians for $199. topol tells his patient he just saved a $100 technician’s fee.

>> so are we close to using this to say i’m going to diagnose you and prescribe four or five apps instead of four or five medications?

>> well, these days i’m actually prescribing a lot more apps than i am medications. you can take the phone and make it a lab on a chip. you can do blood tests, saliva tests, urine tests, all kinds of things. sweat tests through your phone. this is a powerful device.

>> and we’ll just have you hold that on there like that.

>> reporter: topol’s patient, ron thompson, is dealing with several significant heart issues.

>> you saw that on a phone. didn’t you just — weren’t you just amazed the first time you saw that?

>> absolutely. it’s like having an ecg machine hooked up to me and shaving my chest and sticking, you know, stick ’em on there and putting electrodes or whatever, but yeah, no, this is incredible.

>> reporter: topol also uses a portable ultrasound, a v-scan to image ron’s heart.

>> so get a window. there’s the aorta. you see —

>> i sure do.

>> reporter: the v-scan is made by ge, a parent company of nbc.

>> can you see that? see how strong that is coming together?

>> reporter: he does in the office what would normally be a separate test costing $800.

>> there’s 20 million, over 20 million echocardiograms done a year. so 20 million times $800, that’s a lot of money. probably 70, 80% we can get rid of just by having this as part of the physical exam.

>> i was surprised when you saw ron that the technology did not get in the way of the doctor/patient relationship.

>> actually i think it helps make the whole interaction much more intimate, because now i’m sharing the results in realtime. there’s so much technology now that we could — by using digital structure that exists today, that we could make the office visit an enjoyable thing. not only that, nancy, but it doesn’t have to be in person. there’s no reason why a lot of office visits, if not most, could be done remotely.

>> ron could take his ekg at home, send —

>> yes. we’d be looking at it together. or if i got him a wireless ultrasound and he just puts it right there and i say, okay, take a deep breath, i could be watching it in realtime. anything that we can do can be done remotely.

>> reporter: when topol came to scripps in san diego from cleveland, he started a new chapter in his life.

>> when you moved here in 2006, you had just left the cleveland clinic under not very happy circumstances.

>> right.

>> reporter: he had a rep contusion for brashness. he questioned the safety of the hugely profitable pain killer vioxx and eventually forced it off the market.

>> i resigned after having been there 14 years. it was a significant part of my career.

>> do you think, wow, i’ve done a really great job making health care better or do you think, damn, there’s so much yet to do?

>> i feel the damn, there’s so much to do problem. i feel that big-time.

>> do you ever think about how you’re going to die?

>> yeah, i do sometimes. you know, i watched my mother die at a very young age, in her early 50s, with leukemia. my father was an end-stage diabetic. he went blind at age 49.

>> reporter: topol uses dna testing and monitoring to guide his daily life. he refuses to use elevators and his day is spent walking from building to building. he incorporates an hour of exercise into virtually every day, no matter how busy. trying to live the life he thinks we’ll all be living in the near future.

>> how did you find out about that?

>> reporter: at lunch we pulled out what we were told is one of his weaknesses, tortilla chips.

>> will you partake?

>> oh, yeah, it’s hard to resist.

>> okay, come on. handful.

>> reporter: they are loaded with carbohydrates, which trigger glucose.

>> yeah, this is my guilty pleasure here.

>> reporter: so out comes his cell phone.

>> i can look at my glucose every minute. i don’t want to look at it every minute, but i can. so i can just turn it on, my glucose. fortunately i haven’t had enough chips yet. it’s 107.

>> how does it know that?

>> i have a sensor on.

>> where?

>> i have it on my abdomen, but i’ll show you what it looks like. it’s like that. touching the skin.

>> so that sends a wireless signal to this?

>> yes.

>> and if you were a diabetic and you had this, you could then send this message to your physician or to your computer.

>> oh, yeah.

>> and you could start to see triggers and trends and follow this?

>> sure, oh, yeah.

>> and there goes the lifestyle change?

>> you got it.

>> reporter: eric topol is a man who looks way over the horizon, and everywhere he looks, he sees a cell phone.

>> in the future, let’s assume i have heart disease, what could this tell me about impending trouble?

>> well, we’re working on a project that will take a nanosensor in the bloodstream that is smaller than a grain of sand and it will — it will pick up a signal when you have cells that are coming off, shed into the bloodstream, coming off from the artery lining, which is a precursor to a heart attack. and then you will get on your phone a special heart attack ring tone, which will warn you within the week or two weeks that you are very liable to have a heart attack. i know it sounds a little invasive putting this little tiny, smaller than a grain of sand in your blood, but what that will do of having your body under continuous surveillance, talking to your phone, that’s the future of medicine. so this is the heart rate.

>> reporter: this is his newest passion, the busy mobile wrist monitor. topol was involved in its development. everything a hospital intensive care unit now monitors, this does wirelessly.

>> so if my 90-year-old father is discharged from the hospital, it’s conceivable he could go home with something like this and a doctor could monitor him remotely?

>> absolutely.

>> reporter: his book lays out how the digital revolution will create better health care.

>> you write in your book that medicine is currently set up to be maximally imprecise.

>> medicine today is about as much wasteful as one can imagine. so let’s just take drugs in this country, prescription drugs. 350 billion a year, a third of which is total waste. we’re giving a drug that doesn’t work, in fact even worse now, we’re giving drugs that backfire with side effects. so that’s $100 billion plus just from the prescription medications. and what about mass screening? every woman should have a mammogram every year, colonoscopy, psas, it’s really medicine dumbed down. it’s treating everyone the same. that’s crazy. each of us are truly unique in every way.

>> what does the patient of tomorrow look like?

>> the patient of tomorrow is the biggest switch. people need to take ownership. they need to seize the moment and seize the data. the new medicine is plugged into you. it’s understanding you, which we’ve never really done before, and you drive it. you’ve got the data and you’ve got information that you never had before. wouldn’t you like that information? most people would. and wouldn’t you like to be helping to call the shots?

>> fascinating story. our thanks to doctors topol and snyderman for that.

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India and its Future!

I believe that the enlightenment, which started from India and then went around the world, is coming back to India to start another iteration.

This is an inspiring speech!

There seem to be a new younger leadership of India waiting in the wings.

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IITK in the 60s

Uday Sengupta

My very dear friend UDAY SENGUPTA, who, unfortunately, passed away recently.

This picture now makes me feel sad. Uday was a wonderful artist.

{Note: Here are my current views on Death}

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Sunil Dhawan

My good friend, Sunil Dhawan, who I have always admired for his level-headedness.

{Note: Here are my current views on Life}

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Vinay Sushil Ashok

Here I am with my room mate, Ashok Dhawan, on the right, and dorm neighbor, Sushil Handa in the middle. This was one of the moments of relaxation from studies and antics. My room number was 113 in the first year and 213 in the subsequent years. Handa’s room number was 111 and 211 respectively. It is amazing that such small details still exist in the memory.

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It was a wonderful life then. It is a wonderful life now.

The world around you is what you make it.

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Vinaire

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Death

Angel_of_Death

At death, the body disintegrates into physical particles (atoms and molecules), and the identity that was the body is dissolved. Similarly, the observing and thinking part of the person (the living soul) also disintegrates into considerations (thoughts, memories, etc.), and the identity that was the person is also dissolved. That is my current understanding.

However, the particles and considerations remain and they can recombine into another “body plus living soul” configuration. There is infinity of such recombination.

What are the ultimate laws underlying this disintegration and reintegration, I don’t know the details at the moment. But this seems to be going on forever like complex cycles of some eternal wave according to Hinduism.

Nirvana is something different altogether. It happens to a live soul. In my opinion, nirvana is like de-condensation of CONSIDERATIONS. It is the separation of perception-point from all its considerations. This is called giving up of all attachment in Hinduism. One then sees things as they are without any filters as in Buddhism. There is no individuality in terms of attachment to considerations. A perception point is the same as any other perception point. It does not add anything to what is observed or experienced.

Nothing arrives at Nirvana. it is what remains after all attachments are dissolved. I call it a perception-point. But even the perception-point dissolves at parinirvana by merging into its own manifestation… something like electron merging into positron.

Parinirvana is probably what occurs at death, where the live soul, that was already reduced to a completely detached perception-point, merges back into its own manifestation, extinguishing both. The laws of disintegration and reintegration are thus bypassed. But this is only my speculation.

The basis of this speculation is removal of all inconsistencies that I am aware of at this level.

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Out of Body Experience

OOBE

A friend recently sent me an article Who Am I? The question of one’s identity This article describes a “spiritual” experience that I have myself experienced. I would like to comment on the following experience from this article.

I was lying in bed not yet asleep when my consciousness shifted and I became aware of another reality. The sense of being in my bedroom and even of being in my body disappeared. I expanded in a spherical way and finally found myself in an unlimited space. Imagine yourself being somewhere in the universe. You can see the stars all around you. Then take the stars away, that was the space I was in. Just me and unlimited space. It impossible to describe it accurately. I have to resort to our mundane language to give you some idea what it was like. The vastness of that space is beyond description. My perception was spherical, and there was a strong sense of duality of me and that infinity. There were no directions, there was nothing else. Nothing to grab on to. That made me extremely afraid. I desperately wanted to get back to my body. At least that was something I could grab on to. I needed limitations, I could not deal with unlimited emptiness. It was a long and hard struggle, requiring all my will power to get to my body.

This is very similar to my experience that I documented in Chapter 18 of My Introduction to America. It still sends chills through me whenever this happens again. I have gotten somewhat used to it now.

What do I make of this experience? Well, it is something quite subjective. It contains a very unusual sensation that is difficult to get used to completely. It usually happens soon after hitting the bed after an active day. It cannot be willed. It simply happens.

Since working on the Philosophy Project, the “I” appears to me as if it is the center of all the considerations that I hold. By considerations, I mean, thoughts, ideas, assumptions, expectations, suppositions, conjectures, speculations, etc. The existence of “I” seems to depend on all the considerations that I feel attached to. It seems that if I could let go of all my considerations, and view them objectively only, then the “I” would simply reduce to a perception-point. There would no longer be an individuality or identification remaining.

So, what is happening in that experience described above. I have read several people, such as Swami Vivekananda and Aleister Crowley, giving account of a similar experience.  It is almost like the considerations detaching themselves from the “I” and receding from it, and the “I” being reduced to a perception point. It may be described as a process in which “I” is undergoing a de-condensation.

So, the infinite space that is experienced may simply be the impression coming from the final few considerations left. It is what the “I” is reduced to.  “I” has nothing to grab on to but itself; and if this is not acceptable then appropriate considerations would be pulled back in. Though after this experience, the person may not feel the same again.

However, I do not think that at any point the life is threatened. The body is still there and very much alive. What may go away is the subjective attachment to it. The perception may become clearer, and the sense of rationality simpler. One may start looking at everything questioningly as if from a new pair of eyes.

What the above article calls ‘mind’, I refer to it as ‘unknowable’ in the many posts that I have written on this blog. This is because anything that may be stated about the ‘unknowable’ would simply be a consideration arising out of whatever ‘unknowable’ is. We are then looking at the consideration that has arisen and not at what it has arisen from.

There is nothing absolute or permanent. ‘Unknowable’ is unknowable because we cannot even say if it is absolute or permanent. So, I disagree with the following statement from this article.

“This is called the Dharmakaya, the body of realty, the essence, the absolute. This is the essence of our being, it is always there, it will always be.”

Otherwise, it is a good article.

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