This week a story on a recent breakthrough for dissolvable medical implants got me thinking about humanity’s past with implants and medical devices. Obviously, the clear place for my Science Fiction addled, overly geekified brain to jump to was Star Trek and the Borg.
Don’t Judge me.
Star Trek has a long-term relationship with technology and innovation, inspiring many technological advances, albeit mostly non-health-related ones. However, the Borg represented the potential darker side of technology and misuse of it, particularly in the realm of body modification and cybernetic implants. With their crazy ocular devices, robotic limbs and constant uplink to the Collective, the Borg terrified me when I watched First Contact as a kid. In retrospect, I see a lot of similarities between where we are today with medical device implants, crazy homemade devices and discoveries like those dissolvable implants and the Borg. My goal for this week was to first look at a brief of implants and medical devices in humans, and then to take a look at some of the very Borg-like technologies we use today. As a disclaimer, I in no way claim to be an expert either on Star Trek or the field of devices and implants (which is very wide, and overly simplified here), but instead put myself forward as a geek with too much time on her hands, and too much access to the internet and all the glorious things you can learn on it.
With the broadest interpretation, humanity has been mucking around with implants for quite some time. However, Mayan and Egyptian dental implants, frequent attempts at hip replacements since the 1800s, and George Washington’s (not so) wooden teeth aside, the more modern approach to implants and medical devices goes back to roughly 1940s, when Dr. Austin Moore performed the first (metallic) hip replacement. In 1954 Leslie Gordon Percival Shiers published his preliminary report on the design and outcomes of the first knee replacement surgeries. Paul Winchell patented the first design for an artificial heart in 1956, with the assistance of Dr. Henry Heimlich (yes, *that* Dr. Heimlich). The first total artificial heart transplant was performed in 1969 by Dr. Denton Cooley, without authorization, and kept the patient alive for three days before a donor heart was found to replace it.
In 1976, recognizing the importance of oversight of the rapidly developing field of medial devices congress added the Medical Devices Amendments to the Federal Food, Drug and Cosmetic Act (FD&C). This placed the approval of medical devices for marketing in the United States under the responsibility of the Food and Drug Administration, where it has remained ever since, albeit with a few updates. These days, 3-4,000 applications are submitted to the FDA each year for approval. More importantly, the complexity of the devices has substantially increased. The Institute of Medicine’s report on the FDA’s approval process in 2001 showed that the average number of pages in each application has more than doubled from 164 pages in 1993 to 369 pages in 2008, almost entirely because of the increased complexity of medical devices. (Pages 149-52)
The current state of medical devices, implants and crazy cyborg-like technology is rapidly advancing. These days a large portion of implant-tech (medical or otherwise) is venturing much further into “Borg Territory”. Borg “Nanoprobes” have been realized in the form of nanotechnology, which can be used for almost anything ranging from monitoring heart attacks and cancer growth, to creating a ruckus over sunscreen safety , to developing a carbon nanotube ‘yarn’ that can serve as artificial muscle. The ocular implants of The Borg aren’t off limits either. Steve Mann created his own system in the 1980s and though the current version looks relatively normal, the first few iterations of his design are definitely Borg-like in appearance. Most of technological and implant developments that I found seem to lack the more sinister implications of Borg technology. It’s probably still to early to tell if our society will keep it that way, or manage to mess it up somehow, but I think I’d rather take the positive outlook than the negative. I could continue to list off various contributions of the Borg and Star Trek to technology and the ever-advancing field of cybernetics, implants and medical devices, but there are too many to count.
Besides, someone let William Shatner make an entire two-hour special on the topic and let’s face it, he’s much funnier than I am.