eHealth Medical Fiction - "Cell" by Robin Cook

I just finished a page turner by Robin Cook called "Cell". I knew from the beginning that it was an eHealth type of medical fiction. It features a smartphone app called iDoc that promises almost to take over the role of the personal physician. I suspected while reading the influence by Eric Topol, who must be one of the greatest champions for spearheading the medical smartphone revolution.

I was not too surprised to find that Robin Cook does acknowledge Topol at the end of the book. For a while I was concurrently reading Topols' "The Patient Will See You Now" and "Cell".  Robin Cook wrote "Cell" in 2014 and he credited Topols' "The Creative Destruction of Medicine".  Reading the medical fiction is  just a diversion. If you really want to learn about how the smartphone will revolutionize medicine - read Topol.

Medicare should be a major department for all Americans, just like Education and Defense. The author appears to argue like this in the book as he alludes often to the Affordable Care Act and Obamacare. The villain is a Health Insurance Company bent on making billions with the miracle app. The iDoc app is wonderful as the algorithms on the smartphone help to prevent illness and conditions. Health advice is immediate and always accessible.

Unfortunately, the app takes a turn for the worse and the "heuristics" start killing off patients in the alpha testing.  That involves what I think is the only science fiction element in the story - a nano-chip implanted in diabetes patients that is remote controlled by wireless radio signals releasing doses of insulin.  In real life the FDA has approved an "artificial pancreas" of sorts - a network of devices - that automagically monitors and controls blood sugar levels - it just doesn't work on the nano scale.

Just saw over at the Geek Doctor blogspot there is a guest blog by Seth Berkowitz, MD about  Apple’s CareKit and ResearchKit frameworks and the HealthKit API being used at BIDMC. Engaging patients in their health like that is a step towards a kind of iDoc.
  

Musing on the Interaxon Muse Meditation Headband

"For this calibration, find a comfortable position and take a deep breath".

The computer brain interface world is getting interesting. The first time I heard about these types of MUSE brainwave sensing devices was an experiment where they trained people to move a cursor on a computer screen using their brain waves and a EEG headband. Maybe it was the MUSE - not sure. The next thing they did was have those same people change the colour of the floodlights on Niagara Falls and the CN Tower using their entrained brainwaves.

 I have seen more than several research projects now that have involved the Interaxon Muse headband - a device that self-directs users into a calm state of meditation by reading their brainwaves through an EEG headband and translating the data into a meditation tracking app. It may be just the start before EEG caps and gels and wire attachments are a thing of the past.

The McMaster university library recently started loaning out this device so instead of buying one (about $400) I have borrowed one for a week. Mind you, I have 35 years of meditation experience in a variety of schools and techniques and am not expecting a device like this to teach me anything. But after taking an 8 week online mindfulness course - just videos and online instructions - I believe that meditation can be taught through technology.

After downloading the app and fumbling around trying to fit it on my head - should have looked at the visuals in the instructions -  I learned how to sync my brainwaves using the app on the ipad. I tried a 3 minute meditation in the living room while the TV was on, a laptop was playing a video in the background and I was talking to my wife who was doing her yoga exercises. My brainwaves during those 3 minutes were in the noisy/active category. I had scored no calm points and I heard zero "birds". Hearing birds means that your brainwaves are staying in a calm meditative space. Seeing a graph of my brainwaves is actually very interesting but scoring points for meditating well and being asked if I want to share that on Facebook or Twitter is another thing. Tempting though to show all my friends on social media what a noisy mess my brainwaves are - No!

I was sort of impressed with the app interface and the instructions by the MUSE meditation guide. The next time I tried it I sat in my meditation room on my meditation cushion and zabuton. I extended the time to 7 minutes. I chose the default beach imagery with the sound of lapping waves and wind. If you hear the wind, it is actually the sound of your own brainwaves making noise. You are not watching your breath. I sat in the half lotus posture with my hands in my lap, a classic meditation posture I have practiced for years. The resulting graph of my brainwaves after 7 minutes indicated that I had no active or noisy points - 98% calm state of mind and about 100 birds. I could actually hear the birds in the background if I turned up the volume.  Here is a picture of my stats. In my last 20 minute sessions the batteries in the MUSE drained and I had to resume twice so the stats are all thrown off.

It is getting interesting but I spent the rest of the day thinking that I have been under surveillance with my brainwaves subjected to mechanical replication and analysis. This experience was not at all a natural process, in spite of the kind and soft voice of the human guide behind the algorithms on the app. My gurus had years and years of training and practice in meditation before they were allowed to teach.  I didn't let that get to me because I am fascinated with the technology.

The next sitting session I tried 20 minutes - about the amount of my usual meditation time these days. The result was 100% in the calm space, over 200 birds, and no "recoveries" or straying outside the calm zone with distracted thought or lapse of attention to mindfulness of breathing. And that was just a "normal" session for me.

I am really impressed with this device but I am sure that I don't need it having learned the art and science of meditation the traditional way - sitting at the feet of the masters, going on retreats, and practicing daily. My real question and concern is how will this device work with digital natives and those new to meditation?

We live in a world of secular ethics and this device does not come attached to any religious ideology. We all know by now that a mindfulness of breathing practice cuts across the sectarian world. Creating calm brain waves just requires the right guidance and intervention. Is total reliance on the MUSE soulless and alienating?  Not necessarily, though I would probably recommend an online mindfulness of meditation course called Palouse Mindfulness rather than the MUSE for a true beginner - especially ones who are remote from teachers and centres and can't afford the cost. One of the practices in one of the major schools of Tibetan Buddhism is Lam Rim. Lam Rim literally means "gradual path". The gradual path to meditative calm is the best way.


Here is one tip from my Zen teacher on meditation that will help anyone understand the nature of mind and meditation. Sitting across from me at a table the teacher gave me a piece of paper and a pencil. He asked me to draw a small line to count each time I had a thought. It became obvious to me that the page would quickly fill up with counts of scattered thoughts. After sitting in meditation practice, the number of counts becomes noticeably fewer. Where did all those thoughts go? It is just a state of being.