Alongside warfare and trade, medicine is one of the great human enterprises that stands to gain a great deal from future advances in technology. In fact, medical technology is one of the most rapidly-advancing fields of our day.
Improvements in such techniques as microsurgery, gene therapy, laser and ultrasound surgery, as well as more traditional methods, have steadily improved both the lifespan and quality of life of our species. If anything, these trends seem set to acccelerate in the future.
Injury and Reconstruction
From the simple poultices, splints and crude prosthetics of earlier times, medical science has made great leaps forward in the treatment of injury. In particular, the field of microsurgery has allowed miraculous feats such as the reattachment of fingers, ears, toes and even entire limbs possible.
In the case of severe injury, stabilisation of the patient is paramount. Lost blood must be quickly replaced, and any shock effects dealt with. If dangerous materials such as glass or bone splinters are present, the surrounding tissue needs to be protected.
Research into biochemistry and immunology is already promising such new products as an artificial blood substitute that could be used to quickly replace lost blood and keep the patient alive until a proper tranfusion can be obtained. Quick-response teams would carry this fluid and be able to save many more lives. It would be a standard component of a trauma pack. Eventually, truly artifical blood would be available, sidestepping current problems regarding blood-typing and dangers of infection.
"The Hip-Bone's Connected to the... Thigh Bone..."
Prosthetics have come a long way from the days of mediaeval sword-holding gauntlets and the notorious pirate's peg-leg. The future holds even greater promise. Many SF settings presuppose the technology to create a nerve/machine link, so that artificial devices can be controlled by direct nerve impulse. If such tech is available, then artificial limbs powered by servos and actuators could effectively replace a damaged or lost limb. How much practice such a device would require to use is uncertain, but the possibility is there.
Another possibility is regeneration. Many animals, such as starfish, can regenerate an entire body from just a fragment, and even vertebrates such as some lizards can regrow lost tails. When an embryo develops into a human being, the limbs are created by means of a "cascade" reaction. As one part of a developing limb finishes, so the next stage begins. As a result, no living cells in a completed limb will "know" how to re-grow if the limb is damaged beyond repair. However, the use of so-called "stem cells", which have not yet categorised themselves into types, hold the hope that such regeneration will be possible.
Of course, a fully-developed limb will take some time to re-grow, perhaps requiring an extended period of hospitalisation. Perhaps another method would be to grow the required body-part in isolation from the rest of the body, grafting the culture in place when it is finished.
Disease and Treatment
Looking to the future, there are many possible new weapons in the fight against disease. Antibiotics are beginning to fail against new, tougher bacteria, but research into bacteriophages (bacteria-killing viruses) is very promising indeed. In fact, the use of tailored viruses is already being used in gene-therapy, and would be the prime delivery agents of new genetic material. Such therapies could wipe out genetically-realated illnesses such as haemophilia.
While viruses take more specialised techniques to kill at present, the likelihood remains that advances in chemistry and nanotechnology will enable medical science to create hunter-killer nanites capable of detecting and destroying any organism with alien DNA. Of course, our own symbiotic microbes would suffer from this approach, so it's more likely that a hunter-killer would have to be programmed with the DNA signaure of its target. The upshot of this is that epidemics may at first take hold quite strongly until the virus's genome can be sampled and used in the counter-agent. While not perfect, such technology would greatly improve upon current response times to new organisms.
"He's Dead, Jim"
The point at which death actually occurs is rather tricky to pin down. At one time, it was believed that death occured when breathing stopped. Later, the patient was pronounced dead when the heart stopped. Presently, death is said to occur when brain activity ceases. These terms all have one thing in common. The patient is lost and considered dead when all hope of recovery is gone.
Future techniques are likely to make this point even blurrier than it is today. If, for example, some means were available to "reboot" a dead brain (and research is being made into this field even as this article is being written) , then the point of braindeath no longer becomes the poin to f death. In fact, as long as the delicate neural structures could somehow be kept largely intact, the recovering patient may have no more damage than a concussion victim. If such techniques become available, then death could only occur when the body is damaged beyond recovery, probably by decomposition. Keep those stasis tubes handy, folks!
Gilding the Lily
All the above techniques revolve around preventing or repairing trauma of one kind or another. However, as a lot of modern SF likes to believe, things aren't likely to stop there. Maybe one of the most promising (and frightening) possibilities is the use of medical technology to improve upon the normal human template.
The most obvious place to start is cybernetics. While prosthesis patients are likely to be the first recipients of this kind of technology (after all, if you MUST lose your arm then it's something of a compensation to have one that works better than the original), it's almost inevitable that some individuals, probably a little unbalanced at that, will want to "trade up" their old body parts for shiny new ones. However, cybertechnology has a few hurdles to cross before it gets underway. Where synthetic materials protrude from bare flesh, the surrounding skin is likely to be prone to infection. It if keeps trying to heal, the area is likely to be constantly a little sore and itchy. While not extremely dangerous, it could try a patient's patience (no pun intended). Such concerns may be a major or minor factor in your game, but they provide food for roleplaying ideas.
Apart from jamming hardware into one's flesh, other options are available. Similar to cybertech, biological implants, grown from tailored cell cultures, could become an important part of life in the future. From simple "spare parts" technology, bioware could include a veritable treasure trove of valuable wares, from simple glands for drug transmission to exotic creations such as toxin filters to clean dangerous particles out of breathed air, or more sensitive olfactory sensors to improve senses. If profound genetic manipulation becomes possible (or legal), later generations of humans may have all kinds of advantages over their ancestors. Forming as the foetus forms, gene-designed bioware would have many advantages over surgical techniques. The only limits are those of biology, but I personally feel that while subtle improvements, such as improved longevity or immune systems, may be welcomed, we would probably shy away from more profound changes in our bodies and natures.
© Mark Peoples 2001.