To end permanent, physical injuries, our society has to make a choice: Do we play God with our human biology or do we become part machine?
Thus far in our Future of Health series, we've focused on the future of pharmaceuticals and curing diseases. And while illness is the most common reason we make use of our healthcare system, the less common reasons can often be the most grave.
Whether you were born with a physical disability or suffer an injury that temporarily or permanently limits your mobility, the healthcare options currently available to treat you are often limited. We just haven’t had the tools to fully repair the damage done by faulty genetics or severe injuries.
But by the mid-2020s, this status quo will be flipped on its head. Thanks to advances in genome editing described in the previous chapter, as well as advances in miniaturized computers and robotics, the era permanent physical infirmities will come to an end.
Man as machine
When it comes to physical injuries that involve a loss of a limb, humans have a surprising comfort with using machines and tools to regain mobility. The most obvious example, prosthetics, have been in use for millennia, commonly referenced in ancient Greek and Roman literature. In 2000, archeologists discovered the 3,000-year-old, mummified remains of an Egyptian noblewoman who wore a prosthetic toe made of wood and leather.
Given this long history of using our ingenuity to restore a certain level of physical mobility and health, it shouldn't come as a surprise that using modern technology to restore full mobility is being welcomed without the slightest protest.
As mentioned above, while the field of prosthetics is ancient, it's also been slow to evolve. These past few decades have seen improvements in their comfort and lifelike appearance, but it's only in the last decade and a half that true progress has been made in the field as it relates to cost, functionality, and usability.
For example, where once it would cost up to $100,000 for a custom prosthetic, people can now use 3D printers to build custom prosthetics (in some cases) for less than $1,000.
Meanwhile, for wearers of prosthetic legs who find it difficult to walk or climb stairs naturally, new companies are employing the field of biomimicry to build prosthetics that provide both a more natural walking and running experience, while also cutting the learning curve needed to use these prosthetics.
Another issue with prosthetic legs is that users often find them painful to wear for extended periods of time, even if they’re custom built. That’s because weight bearing prosthetics force the amputee’s skin and flesh around their stump to be crushed between their bone and prosthetic. One option to work around this issue is to install a kind of universal connector directly into the amputee’s bone (similar to ocular and dental implants). That way, prosthetic legs can be directly “screwed into the bone.” This removes the skin on flesh pain and also allows the amputee to buy a range of mass produced prosthetics that no longer need to be mass produced.
But one of the most exciting changes, especially for amputees with prosthetic arms or hands, is the use of a fast developing technology called Brain-Computer Interface (BCI).
Brain powered bionic movement
First discussed in our Future of Computers series, BCI involves using an implant or a brain-scanning device to monitor your brainwaves and associate them with commands to control anything that’s run by a computer.
In fact, you might not have realized it, but the beginnings of BCI have already begun. Amputees are now testing robotic limbs controlled directly by the mind, instead of through sensors attached to the wearer’s stump. Likewise, people with severe disabilities (such as quadriplegics) are now using BCI to steer their motorized wheelchairs and manipulate robotic arms. By the mid-2020s, BCI will become the standard in helping amputees and persons with disabilities lead more independent lives. And by the early 2030s, BCI will become advanced enough to allow people with spinal injuries to walk again by relaying their walking thought commands to their lower torso through a spinal implant.
Of course, making smart prosthetics isn’t all that future implants will be used for.
Implants are now being tested to replace entire organs, with the long-term goal of eliminating the wait times patients face when waiting for a donor transplant. Among the most talked about organ replacement devices is the bionic heart. Several designs have entered the marketplace, but among the most promising is a device that pumps blood around the body without a pulse … gives a whole new meaning to the walking dead.
There’s also an entirely new class of implants designed to improve human performance, instead of simply returning someone to a healthy state. These types of implants we’ll cover in our Future of Human Evolution series.
But as it relates to health, the last implant type we’ll mention here are next-generation, health regulating implants. Think of these as pacemakers that actively monitor your body, share your biometrics with a health app on your phone, and when it senses the onset of illness releases medicines or electric currents to rebalance your body.
While this might sound like Sci-Fi, DARPA (the US military’s advanced research arm) is already working on a project called ElectRx, short for Electrical Prescriptions. Based on the biological process known as neuromodulation, this tiny implant will monitor the body's peripheral nervous system (the nerves that connect the body to the brain and spinal cord), and when it detects an imbalance that may lead to illness, it will release electrical impulses that will rebalance this nervous system as well as stimulate the body to heal itself.
Nanotechnology swimming through your blood
Nanotechnology is a huge topic that has applications in a wide variety of fields and industries. At its core, it's a broad term for any form of science, engineering, and technology that measures, manipulates or incorporates materials at a scale of 1 and 100 nanometres. The image below will give you a sense of the scale nanotech works within.
In the context of health, nanotech is being investigated as a tool that could revolutionize healthcare by replacing drugs and most surgeries entirely by the late 2030s.
Put another way, imagine you could take the best medical equipment and knowledge needed to treat a disease or perform surgery and encode it into a dose of saline—a dose that can be stored in a syringe, shipped anywhere, and injected into anyone in need of medical care. If successful, it could make everything we discussed in the last two chapters of this series obsolete.
Ido Bachelet, a leading researcher in surgical nanorobotics, envisions a day when a minor surgery simply involves a doctor injecting a syringe filled with billions of pre-programmed nanobots into a targeted region of your body.
Those nanobots would then spread out through your body searching damaged tissue. Once found, they would then use enzymes to cut the damaged tissue cells away from the healthy tissue. The body's healthy cells would then be stimulated to both dispose of the damaged cells and regenerate the tissue around the cavity created from the removal of the damaged tissue. The nanobots could even target and suppress surrounding nerve cells to dull pain signals and reduce inflammation.
Using this process, these nanobots can also be applied to attack various forms of cancer, as well as various viruses and foreign bacteria that may infect your body. And while these nanobots are still at least 15 years away from widespread medical adoption, the work on this technology is already very much underway. The infographic below outlines how nanotech could one day re-engineer our bodies (via ActivistPost.com):
Using the umbrella term, regenerative medicine, this branch of research uses techniques within the fields of tissue engineering and molecular biology to restore the function of diseased or damaged tissues and organs. Basically, regenerative medicine wants to use your body's cells to repair themselves, instead of replacing or augmenting your body's cells with prosthetics and machines.
In a way, this approach to healing is far more natural than the Robocop options described above. But given all the protests and ethical concerns we’ve seen raised these past two decades over GMO foods, stem cell research, and most recently human cloning and genome editing, it’s fair to say that regenerative medicine is going to run into some heavy opposition.
While it’s easy to dismiss these concerns outright, the reality is that the public has a far more intimate and intuitive understanding of technology than it does biology. Remember, prosthetics have been around for millennia; being able to read and edit the genome has only been possible since 2001. That’s why many people would rather become cyborgs than have their “God-given” genetics tinkered with.
That’s why, as a public service, we hope the brief overview of regenerative medicine techniques below will help remove the stigma around playing God. In order of least controversial to most:
Shapeshifting stem cells
You’ve probably heard a lot about stem cells over the last few years, often not in the best light. But by 2025, stem cells will be used to heal a variety of physical conditions and injuries.
Before we explain how they’ll be used, it’s important to remember that stem cells reside in every part of our body, waiting to be called into action to repair damaged tissue. In fact, all of the 10 trillion cells that make up our body originated from those initial stem cells from inside your mother’s womb. As your body formed, those stem cells specialized into brain cells, heart cells, skin cells, etc.
These days, scientists are now able to turn almost any group of cells in your body back into those original stem cells. And that is a big deal. Since stems cells are able to transform into any cell in your body, they can be used to heal almost any wound.
A simplified example of stem cells at work involves doctors taking skin samples of burn victims, turning them into stem cells, growing a new layer of skin in a petri dish, and then using that newly grown skin to graft/replace the burnt skin of the patient. At a more advanced level, stem cells are currently being tested as a treatment to cure heart disease and even heal the spinal cords of paraplegics, allowing them to walk again.
But one of the more ambitious uses of these stem cells makes use of newly popularized 3D printing tech.
3D bioprinting is the medical application of 3D printing whereby living tissues are printed layer by layer. And instead of using plastics and metals like normal 3D printers, 3D bioprinters use (you guessed it) stem cells as the building material.
The overall process of collecting and growing the stem cells is the same as the process outlined for the burn victim example. However, once enough stem cells are grown, they can then be fed into the 3D printer to form most any 3D organic shape, like replacement skin, ears, bones, and, in particular, they can also print organs.
These 3D printed organs are an advanced form of tissue engineering that represents the organic alternative to the artificial organ implants mentioned earlier. And like those artificial organs, these printed organs will one day reduce the shortage of organ donations.
That said, these printed organs also present an additional benefit for the pharmaceutical industry, since these printed organs can be used for more accurate and cheaper drug and vaccine trials. And since these organs are printed using the patient’s own stem cells, the risk of the patient’s immune system rejecting these organs falls drastically when compared to donated organs from humans, animals, and certain mechanical implants.
Further into the future, by the 2040s, advanced 3D bioprinters will print entire limbs that can be reattached to the stump of amputees, thereby making prosthetics obsolete.
With gene therapy, science begins to tamper with nature. This is a form of treatment designed to correct genetic disorders.
Explained simply, gene therapy involves having your genome (DNA) sequenced; then analyzed to find defective genes that are causing a disease; then altered/edited to replace those defects with healthy genes (nowadays using the CRISPR tool explained in the previous chapter); and then finally reintroduce those now-healthy genes back into your body to cure said disease.
Once perfected, gene therapy could be used to cure a range of illnesses, like cancer, AIDS, cystic fibrosis, hemophilia, diabetes, heart disease, even select physical disabilities like deafness.
The healthcare applications of genetic engineering enter a true gray area. Technically speaking, stem cell development and gene therapy are themselves forms of genetic engineering, albeit mild. However, the applications of genetic engineering that concern most people involve human cloning and the engineering of designer babies and superhumans.
These topics we’ll leave to our Future of Human Evolution series. But for the purposes of this chapter, there is one genetic engineering application that’s not as controversial … well, unless you’re a vegan.
Currently, companies like United Therapeutics are working to genetically engineer pigs with organs that contain human genes. The reason behind adding these human genes is to avoid these pig organs being rejected by the immune system of the human they are implanted into.
Once successful, livestock can be grown at scale to supply a nearly unlimited amount of replacement organs for animal-to-human "xeno-transplantation." This represents an alternative to the artificial and 3D printed organs above, with the advantage of being cheaper than artificial organs and further along technically than 3D printed organs. That said, the amount of people with ethical and religious reasons to oppose this form of organ production will likely ensure that this technology never goes truly mainstream.
No more physical injuries and disabilities
Given the laundry list of technological vs. biological treatment methods we've just discussed, it's likely that the era of permanent physical injuries and disabilities will come to an end by no later than the mid-2040s.
And while the competition between these diametric treatment methods will never really go away, by and large, their collective impact will represent a true achievement in human healthcare.
Of course, this isn't the whole story. By this point, our Future of Health series has explored the forecasted plans to eliminate disease and physical injury, but what about our mental health? In the next chapter, we'll discuss whether we can cure our minds as easily as our bodies.