The Intensive Care Unit of the Future
The ultimate future of critical care medicine is surprisingly easy to predict with certainty. The difference between a healthy person and ill one can be reduced to the difference in the way their atoms are arranged. From a broken bone to a broken strand of DNA, illness is ultimately reducible to how the structures that embody life are configured and interact with each other. Today's clinicians can only affect events going on in their patients at the molecular level mostly in indirect ways. We have a little specificity, but no precision. We can introduce molecules (drugs) that turn or on or off certain genes, activate certain molecular mechanisms, or derange or shut down others. Antibiotics do this to flora we consider undesirable or out of control in the patient. Steroids and many other drugs signal genes or, like the pressors, more immediately act on cell machinery. We can poison metabolism and disrupt DNA with chemotherapy and radiation, but we lack the ability, at least clinically, to reset the DNA of a neoplastic cell to its healthy state.
KeywordsIntensive Care Unit Sensor Array Zhongshan Hospital Cowpea Mosaic Virus Image Courtesy
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- 1.Drexler KE. Engines of creation. New York: Doubleday; 1986. Available at: http://www.foresight.org/EOC/EOC_Chapter_3.html#section04of05.
- 3.Drexler KE. Nanosystems: molecular machinery, manufacturing, and computation. New York: Wiley Interscience; 1992.Google Scholar
- 5.Lin T, Johnson, JE, et al. Structure-based engineering of an icosahedral virus for nanomedicine and nanotechnology. The Scripps Institute Scientific Report. La Jolla, CA: Scripps Institute; 2004.Google Scholar
- 6.Clarke AC. Peacetime uses for V-2; V-2 for ionosphere research? Wireless World. February1945:58.Google Scholar
- 7.Thomas L. Lives of a cell. New York: Viking Press; 1974:299.Google Scholar
- 12.Hayflick L. How and why we age. Westminister, MD: Ballantine Books; 1996.Google Scholar
- 13.Holmes OW. The one horse shay and its companion poems. Cambridge, MA: Houghton, Mifflin and Company, The Riverside Press; 1892.Google Scholar
- 14.Kurzweil R. The law of accelerating returns. Available at: http://www.kurzweilai.net/articles/art0134.html?printable=1.
- 15.Becker GS. Get the FDA out of the way, and drug prices will drop. Business Week. September 16, 2002:16.Google Scholar
- 16.The Cato Institute Handbook for the 105th Congress. Section 32. Washington, DC: Cato Institute; 1997. Available at: http://www.cato.org/pubs/handbook/hb105–32.html.
- 17.Smith P. Arrows of mercy. Toronto: Doubleday; 1969:178.Google Scholar
- 18.Lindsay J. Harold Griffiths and the introduction of curare. J Can Med Assoc 1991;144:588–589.Google Scholar
- 20.Gott VL. King of hearts: the true story of the maverick who pioneered open heart surgery. New York: Crown Publishers; 2000.Google Scholar
- 22.Dialysis Corporation of America Annual Report (10-K) for Dec 31, 2004.Google Scholar
- 23.Committee on Metabolic Monitoring for Military Field Applications, Standing Committee on Military Nutrition Research. Monitoring metabolic status: predicting decrements in physiological and cognitive performance. Washington, DC: National Academy Press; 2004.Google Scholar