Hand Star
Leonard McCoy’s Sickbay in the Real World
Apart from being the most iconic franchise in the history of television, Star Trek – from “The Original Series” through “Enterprise” – sparked the imaginations of inventors, scientists, astronauts and those who simply wanted to see its advanced technologies appear in the real world.
Perhaps not surprisingly, that is occurring far more frequently than Gene Roddenberry and his successors predicted. The perennial flip-phone resembles Captain Kirk’s hand-held communicator, for instance, and the Internet is humanity’s first Memory Alpha. But some of the most interesting evolutions from science fiction to fact are occurring in medicine.
Current senior military medical officers believe a rudimentary version of Dr. “Bones” McCoy’s medical tricorder will be fielded with the US military. Not someday. Not in a couple of decades. But soon. Maybe even before the end of this decade.
in fact, the US Army is already beginning to use the first elements of its new Land Warrior battle ensemble, which will upgrade the field soldier from just being a cog in the combat wheel to a central and primary element of a new system-of-systems type approach. The success of this effort up till now is important to medicine since the continuing research and development (R&D) side of this continuous process – Future Force Warrior (FFW) – is examining some compelling advances apart from protecting soldiers from being injured, but in looking after them should they be wounded.
US military casualties in Afghanistan and Iraq already hold the record for the least number of “killed in action” (those who die in combat before they can be treated) of any conflict in the history of warfare. That is basically due to two factors: Advanced body armor that has practically eliminated head and torso wounds and superior medical intervention in the field. That ranges from medics (and Navy corpsmen) who are far better trained and equipped than their predecessors, to surgeons who were placed on the front-lines during the primary combat phase.
As a result, the so-called “golden hour” has become what one Army surgeon calls the “platinum 10 minutes” – the time from the moment a soldier is injured until he (or she) receives life-saving medical care.
Ongoing breakthroughs are aimed at developing armor to protect arms and legs – the primary locations for wounds, mostly from explosions and fragmentation, among US soldiers today. Ultimately, should the final quirks be ironed out, would be the Future Force Warrior prototype, which just about everyone compares with the full-body armor worn by the imperial troops in Star Wars.
But much closer to reality are other FFW components that may well become part of standard military gear in the coming years. For example, systems to constantly monitor a soldier’s vital signs, intake of fluid, patterns of sleep, making that information instantly (and wirelessly) available to any medic. It could even transmit a radio call to the closest field medic should those vital signs show that a soldier has received a wound.
Such a development may not be a hand-held tricorder, but it is getting there.
Soldiers also will wear electronic dog tags that contain their entire medical histories (updated regularly), which makes it possible to tailor any medical intervention, taking into account allergies, how different drugs interact or other medical conditions or recent treatments. That could include updates at each stage of care along the evacuation line from the point of a combat injury all the way back to a hospital in the US.
Every soldier, Marine, sailor and airman also will be provided with a personal first aid kit containing, among other things, a single-handed tourniquet and special blood-clotting bandages to stop bleeding (rapid loss of blood is the number one why soldiers die on the battlefield). Each will also be trained in advanced first aid – and one in six (at least) will receive advanced training as a Combat Life Saver (CLS). While it receives a non-medical rating, the CLS will provide assistance, as required, to regular medics, as well as adding a new layer of on-site support to his or her fellow soldiers.
Corpsmen and medics also are undergoing significant upgrades in both training and equipment. With the addition of a constant stream – and history – of data from every soldier and the capability to “reach back”, with both video and audio, to better medical resources, from the Forward Surgical Team operating within the sound of front-line gunfire to best-in-their-field specialists in the US, the Future Warrior Medic will be able to provide an extraordinary level of medical care within minutes of a combat casualty happening.
A few of these elements are already in place in Southwest Asia; most will be within a matter of months. Others coming along include:
A testing kit using biomarkers to determine the presence and severity of brain injuries
Automatic controls built into ventilators, allowing medics to deliver a level of resuscitation currently only available from intensive-care nurses
Hand-held ultrasound equipment that can pinpoint internal injuries
A digital handbook of diagnostic and treatment protocols medics can carry into combat
Small oxygen generators that can turn ordinary air into medical-grade oxygen
A system that can quickly identify and diagnose 10 biologic weapons threats, including anthrax, smallpox and plague
Replacing blood without the need to use refrigerated blood bags
An advanced, self-contained training simulator for medics (not a holodeck, but also getting there)
While these advances are aimed at providing fast, competent medical treatment to combat personnel, they will also become integral to the medical field capability the US Armed Forces will be able to provide to civilians and enemy combatants.
Before the current conflict, there was no provision for US military medicine to care for children, the elderly or disease and illness not found among the young, physically fit members of the armed forces. Today – and to an even larger extent in the future – such care is part of the training and equipment the Air Force, Army and Navy will bring into combat and to disaster relief and humanitarian missions, too.
Within the careers of some in uniform today, future civilian and military research and development may go even further than Star Trek doctors could do. The Surgeon General of the Army, Lt. Gen. Kevin C. Kiley, has written that he believes one of the “most exciting possibilities in modern medicine” to be the ability to repair or re-grow lost or damaged tissues and limbs. “Regenerative medicine”, Kiley says, is the subject of promising research that he feels “has implications for military medicine in the near future”.
Dr. Leonard McCoy’s sickbay on the Enterprise was set in the 23rd Century, some 200 years into our future. It could very well be, though, that “Bones” would find himself outdated and old-fashioned in the midst of 21st Century combat medicine. We can only dream of the advances to come in the next 50-100 years, let alone the next 200!
Tyr – By The Sword In My Hand
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