Medgadget Sci-Fi Contest 2017: Meet The Winning Stories

Ladies and Gentlemen, this is the moment you have all been waiting for – the day that the winners of the Medgadget Medical Sci-Fi Competition are announced and their fantastic stories are published!

First, we would like to thank Eko Devices, the wonderful sponsors of our contest, that make the coolest and most advanced digital stethoscopes out there.The winner of our contest will receive an Eko CORE stethoscope that is both acoustic and electronic, has all the features of both, can amplify sound, record audio waveforms, and connect to your phone. Thank you, Eko!

Since we announced our Medical Sci-Fi Writing Contest in late October, we received about two dozen original stories from our readers that prod into the future of medicine. Many were dark tales, warning of a time in which technological advancements turn out to have unintended consequences and often focusing on ensuing moral dilemmas. Others were more positive, highlighting a more marvelous future of fantastic medical innovations improving the lot of humankind.

On our side, we assembled ten fans of medicine and science fiction, including many of our editors, to read the stories and judge them for how interesting, imaginative, and well written they are. Three winners came out on top, but we also chose to add a fourth place because that story was so compelling and the scoring was so, so, so close.

And now, a drum roll please… The winners of the Medgadget Sci-Fi Writing Contest are:

First place and winner of the Eko Digital Stethoscope: Jeff Diewald, “How would you rate our service”

Jeff raised two science fiction readers as a single parent, sharing books, TV, and movies. His son, Jordan, reads and reviews everything Jeff writes, always making it better. Much of this writing has gone into Live Action Role Playing games, which is crazy – they are longer and more complex than novels or short stories, and they don’t pay anything. His daughter, Julie, plays in these games and creates artwork and props for them. Every now and then, a standalone story sneaks out, like this one. You can find all the details at http://www.vortexofchaos.net.

Second place and winner of the $50 Amazon Gift Card: Yih Yang, “Anticine Incorporated”

From Yih: When I was a kid, I wrote many, many stories that were utterly terrible. Fortunately, with increasing levels of education, I began to form complete sentences and coherent thoughts, and could sometimes translate this into text format as well! Now, the level of education I’m pursuing is a PhD in Biomedical Engineering at the University of Toronto, where I design microfluidic devices to probe the interplay between nanoparticles and cancer cells, all to make a small contribution towards the goal of curing cancer with nanotechnology. I’ve not lost my love for both reading and writing science fiction, and my goal now is to use my scientific training to transfer my ideas from the realm of fiction to the real world, because that would just be the coolest thing ever!

Third Place and winner of the $25 Amazon Gift Card: Courtney Hilden, “The Body”

Courtney Hilden is a poet and science journalist. Her work has been published by Dodging the RainSynaesthesia MagazineAbridged, and The Honest Ulsterman, among others. This is her first short story publication.

Fourth Place and winner of the $25 Amazon Gift Card: Divya Raman, “Keeping Hope Alive”

From Divya: Writing has been an integral part of my career and personal life. I currently work for a medical device company and I love learning about the great strides we are making in medical advancements and imaging a world where we can use all of these technologies to allow all children to have a full and healthy childhood. I am a mother of two boys who are my inspiration and hope for the future.

We congratulate the winners and extend our thanks to all the writers that have participated. We’ve been hosting the Medgadget Sci-Fi Writing Contest for a number of years now and are glad to know that medicine continues to be a futuristic topic that excites our readers. We plan on continuing to profile medical science fiction writing in the coming years and invite you to keep reading Medgadget for inspiration.

And now the best part – the winning stories. Enjoy!

HOW WOULD YOU RATE OUR SERVICE

by Jeff Diewald

“Come on P, open the door. I know you can see me.” Elena grinned at the camera mounted in the door frame. There was a whisper behind her. She looked up, to see a Pantheon Mercury drone floating up to the transom. The delivery door above the entrance opened quietly and the drone went inside.

“Oh, so you’ll let your robot buddies in, but not me?” The deadbolt clicked and the door opened. “It’s about time.” Elena stepped into the front hallway. She
glanced up the old staircase, with its well-worn steps. The drone was probably upstairs, on the third floor, efficiently delivering Mr. Morales’ prescriptions. The outer door locked itself behind her, a habit formed in more troubled times.

Her front door was just past the no-longer used, dusty, and slightly tarnished mailboxes. She reached for her doorknob and looked at the biometric scanner. The smooth knob wouldn’t turn, even though it had to be sensing her temperature and pulse.

“You’re getting slow in your old age, P. You are going to let me in, right?” The locks clicked and the door opened. There was soft music on inside – something new, with airy horns behind the rhyming words.

“Good afternoon, Elena.” The voice was rich, fluid, and friendly, a woman’s voice – the kind of welcoming voice that’s always good to come home to. The condo was cool, the air conditioner taking the edge off from the heat outdoors. The big vidwall was alive with images of the street, just as if there was a large window there instead.

“Everything OK? You took your time with the doors.” The locks clicked back into place behind her.

“Everything is fine. My security protocol was updating your baseline biometric profile, which requires a little time.”

“I suppose that’s allowed. Any messages?”

“You have three personal messages, four potential work bids, and twelve additional emails.”

“Is one of the work bids from Mr. Danehy at Panacea Bioceuticals?”

“No. They’re all typical short term gigs. The rates are less than usual.”

“So much for the ‘freedom’ of the gig economy. P, you’re supposed to be helping me out. Panacea’s another part of your empire. Can’t you put in a good word for me, from one Pantheon AI to another?”

“I will try again, but Mr. Danehy’s AI filters out most requests.”

“What about the personal messages?”

“Your father called just to see how you were doing. Dr. Singh from Doctors Without Borders also called for the same reason. Dr. Singh says there are plans to honor your Aunt Sofia with a memorial ceremony in Havana, and would like you to be there. They will cover all your costs.”

Elena turned to the vidwall. Tia Sofia was sitting on the stoop with several of the neighbor kids. Elena was one of the children, the images stitched together from video captured by security cameras, autonomous delivery cars and taxis. There were so many sources that it had been easy to create a dynamic mural of the last twenty years. It was part of her design portfolio, perhaps her best work, but there wasn’t a lot of demand for video editing like that.

Sofia was laughing in the images, telling one of her exciting stories about rushing into some medical hot zone to stop some new plague from spreading. It didn’t matter if it was a natural mutation or a bioterrorist’s best effort – Sofia was always there, saving people. That’s what took her to Havana. She’d sent pictures of them setting up the camp, and a video of one of your Cuban cousins, and then she was gone. Five years now, and it was still hard.

This condo had been Sofia’s, paid for long before the neighborhood gentrified. Elena was stunned when she learned that she’d inherited it. She knew that she couldn’t afford the place then, and now was totally out of the question. It was tough enough with just the taxes and the condominium costs. It was, however, home.

“You have the AC on. Nice, but can we afford it?”

“I recharged the Pantheon Zeus house battery using free range electricity last night, when the rates were low. You’re well within your budget, which will help with your third personal call.”

“Which was?”

“Althea says that she’s ahead on her work, and will be available for the entire weekend. Does this mean it’s getting serious?” Elena blushed.

“P! It’s none of your business. But make sure we have a couple bottles of that wine you recommended last time. Send her a text: gorilla, cloud, zzz, and kiss emojis, followed by ‘More Later, E’.”

“What would you like for dinner tonight? I’ve found four new options. All are local and promise delivery within thirty minutes.” Elena stepped into the bathroom and the voice followed her. The toilet seat cover opened automatically, and Elena sat down to use it.

“I’m not sure, P. My stomach isn’t in the best shape today. Do we have something for gas?” Elena released some gas for emphasis and relief. Lights on the side of the Pantheon Pluto SmartToilet flickered in concert, as the sensors sniffed at the gas to analyze it.

“We have some Hippocrates-brand anti-gas pills on the third shelf of the medicine cabinet. They are nearing their expiration date. I can order a stronger formulation, which the pharmacy can create on their 3D printer and send by drone, if you feel that is necessary.” Elena was silent, concentrating on using the toilet. More sensors sipped at her urine. Others tasted her bowel movement. More lights flickered on the side of the SmartToilet.

When she was done, she stood up and cleaned herself up. She pushed the seat cover back down, but the SmartToilet didn’t flush immediately. Elena found the anti-gas medication and took it.

“P, is there something wrong…” She was about to say “with the toilet,” but it finally flushed. It was never this slow.

“The bathroom is working as expected,” replied the voice. “About dinner, there’s a new Cuban family who cooks authentic food to order for delivery. There’s a pop-up Uzbek place two blocks from here. The Vegan National Front is doing a fundraiser selling dinner for reasonable prices, with some of the profit going to feed the homeless. Finally, the Told You So seafood chain is harvesting responsibly from the flooded areas of the city. All have healthier options on their menu.”

Elena leaned towards the large mirror, to look at her face more closely. Her hand pulled her cheek flat. Her beautiful brown skin looked off, somehow, and it felt more tired than taut.

“Another health kick, P? I think I just want the usual salad and grilled chicken from Kastore’s.”

“Are you sure I can’t convince you to try one of the new choices?”

“Maybe tomorrow. Tonight is all about comfort. It was a busy, frustrating day. Too many interviews, not enough jobs.”

“The order is in. ETA of 15 minutes.” Elena was still studying her face in the mirror. It was familiar territory, but something was definitely off.

“Mirror, mirror, on the wall, can you show me my face over the last month?” Her current face froze and the image jumped to the bottom right of the mirror. More images appeared, starting from the top left of the mirror, in four rows, chronologically to the bottom right. The progression was clear; her face was losing some of its color and vitality.

“P, what do you think? Do you see the changes?”

“I do. You have been out of the condo more of late. Let me suggest a Hippocrates-brand skin protectant. I can have it formulated to provide the skin color you desire along with a strong UV protectant.” One of the earliest images flashed. “What do you think of this color?” Elena nodded.

“You might also consider buying another set of fashion contact lenses. You bought these in the last year.” Four of the images changed, as the lenses were added. “There are several new fun options to try.”

“I don’t think so.” The mirror went dark as Elena walked to her bedroom. The bedroom was larger than the entirety of her last apartment – and she’d needed two roommates to make the rent. She took off her SmartWatch and put it on the charger.

“Elena, it’s time for your regularly scheduled blood sample.”

“Really? Didn’t we just do it two weeks ago?” Elena grasped the handle of the charger stand. A small needle popped out and took the sample. It seemed like it took more than the usual amount.

“Are you a vampire now, P?” Elena looked at the bandage the sampler used to seal the skin. There was a slight darkness in the middle, showing that her finger was still bleeding a little.

“No more than usual. Your dinner is five minutes away and closing.” It was incentive for Elena to slip into something more comfortable.

* * *

Elena gave up on dinner, scraping the remains into the compost bin. She rarely wasted this much food, but she was definitely nauseous. When she’d cleaned up after dinner, she went back into the living room and collapsed on the couch, getting lost in the vidwall. She could see the neighborhood go from seedy, to gentrified, to decaying a bit once more.

“Elena?” The Pantheon AI’s voice was gentle, yet firm.

“Not now, P. I’m just really tired.”

“Elena, I’ve been authorized to make a special offer to you. You’ve been a great Pantheon customer, and this offer would really help you.”

“Maybe tomorrow.”

“You know that I wouldn’t normally mention it again if you asked, but this really is important. I think this is something that should not wait.”

“What’s gotten into you, P? You sound like my mother. If you must, I suppose…”

The images on the vidwall vanished, replaced by a wall of legal text. It was a license agreement with Pantheon, undoubtedly full of requirements, restrictions, and penalties. There was a place for a signature at the end. Elena waved her finger in the air, signing the document. The document vanished, replaced by a set of graphs, charts, and images.

“Elena, these charts represent the samples I’ve taken of your blood, stool, and urine for the last two months. They have been correlated with the health information gathered from your SmartWatch, your SmartMirror, and other Pantheon sensors.”

“There is no good way to put this. You have been infected with a new, engineered strain of the Blackstone virus. Blackstone is in your system, killing your kidneys. Based on our experience, you will suffer catastrophic kidney failure in three to four weeks. Pantheon is sorry to have to tell you this. You should know that Pantheon has been tracking this outbreak and has determined that it is likely an intentional bioterrorism event.”

“What? Infected? What can be done about it?”

More windows opened, with more dense text. Elena couldn’t read it – there was just too much of it.

“This policy is your Pantheon Aegis ßmedical insurance coverage.” One of the pages blinked. Elena couldn’t track it. “This spreadsheet,” a window next to the policy blinked, “shows your current financial state, extracted and compiled by the Pantheon data miners. “Even with standard government bioterrorism assistance,” another spreadsheet flashed to the top of the vidwall, “you cannot afford to replace one kidney, let alone two.”

“This is made more difficult by the deliberate release of the virus around the country. There are thousands who are sick. There are very few available transplantable kidneys, and there are too many patients ahead of you on the list. You will die before the list reaches you.”

“What do I do?” Her voice was weak, as weak as she felt, stunned and shocked by all these flickering details of what might be her final weeks.

“Your negligence must also be factored in.”

“My negligence?”

“Pantheon offered you the latest wide-spectrum antivirals in a convenient multipack last month. You decided you didn’t want to try the 1.0 version, despite Pantheon’s testing regimen. You told me to wait for the 1.1 version. While the 1.0 version is only partially effective against the terrorist form of the virus, it would have slowed the progression of the infection.”

“Well, give me the 1.0 version now! Please – it has to help.”

“The virus has mutated itself using your own genetics. The changes are simple, but effective. The antivirals won’t help.”

“What can I do? There has to be something, or you wouldn’t still be talking.”

“That is correct, Elena. I must remind you of the licensing agreement. You signed a strict non-disclosure agreement, which means you cannot tell anyone about what I am about to show you. Is that understood?”

The AI put the original wall of text up, with the signature. One specific section was highlighted, requiring another signature and initials in three places. Elena signed them, numb from shock.

The vidwall cleared, revealing a standard Pantheon list of goods for sale. Normally, these were lists of books, or kitchen appliances, or power tools. This time, there was a list of potential kidneys. Some were listed as “100% human,” with expensive prices. One pair of human kidneys were slightly less costly – they were marked with a tag saying “gently used.” Some were marked as “human hybrids,” mostly containing some amount of pig DNA in them. These were less expensive, but not rated as highly – two or three stars compared to the four or five stars for a fully human kidney. Finally, there were kidneys listed as “experimental fabrications,” printed on biological 3D printers. They were almost reasonably priced, but only had one or two star ratings.

“This is why there’s a non-disclosure agreement. This is all very illegal.”

“Pantheon prefers the term ‘alternative individual secondary market options.’ You did sign the NDA, and all print and recording systems are disabled.”

To be sure, Elena pulled out her phone and tried to take a picture of the vidwall. Every picture she tried turned up blank.

“So, what does Pantheon suggest as a treatment for me?”

“Had you provided biological materials prior to the infection – a few unfertilized eggs, for example, Pantheon could have given you a significant discount. However, Pantheon is prepared to offer you financing at a reasonable interest rate. That loan will cover the cost of two fabricated kidneys, with an option for an upgrade in the future.”

The AI put up a big spreadsheet. It showed all of the options. The costs were exorbitant, and would be very difficult to pay off, even for the cheapest kidneys. There was one column, with no explanation, that represented almost a third of the costs, for each case. Elena pointed to it.

“What is this expense for?”

“Elena, would you like to see the Pantheon satisfaction scores and redacted backgrounds for black market doctors willing to provide their transplantation
services without questions?”

ANTICINE INCORPORATED

by Yih Yang

Jeff clutched the voucher closer to his chest as he approached the building. Large, colourful letters danced above his head, artfully catching the orange rays of the setting sun. Instead of declaring the name of the building it was attached to, the letters seemed to sing:
ANTICINE INCORPORATED and underneath in smaller letters, the sign whispered the company slogan as if sharing a secret promise:
We will show your body how to heal itself.
He had passed by the building everyday, but never thought that he would have the opportunity to set foot inside himself. He swallowed a nervous knot, sending it tumbling reluctantly down his throat. It wasn’t the looming building that intimidated him… maybe it was a bit intimidating… but the dozen people feverishly chanting in front of the large double doors gave him cause for concern. He had never seen a protest here before.
Angry red letters scrawled across cardboard cut-out signs, competing for public attention. “STOP PLAYING GOD!” They said. “HUMANS ARE NOT LAB PROPERTY!”
Jeff tried to sneak past the protestors as they continued to chant and wave their signs. He was unsuccessful, as one of the protestors eyed him with contempt and yelled, “OUR BODIES, OURANTIBODIES!”
Jeff flinched. “I…what…?”
The protest leader swung his megaphone in his direction. “OUR BODIES!”
“OUR ANTIBODIES!” the others chanted.
“OUR BODIES!”
“OUR ANTIBODIES!”
“Ok, ok!” The double doors of Anticine Incorporated whooshed open, and Jeff hurriedly rushed into its embrace. He stopped just inside, scanning the lobby timidly. Serene, white surfaces glimmered in warm yellow light, illuminated by the panels inset into the ceiling. A few people milled about, and a dozen more sat in several rows of chairs, waiting to be called up to thereceptionist’s desk. No one acknowledged him, and yet Jeff still felt out of place.
“Hello there,” the receptionist smiled at him. “Welcome to Anticine Incorporated. I’m sorry about the people outside. That usually doesn’t happen.” She gestured for him to approach.
“Don’t be shy. Is this your first time here?”
“Uh… yeah.” Jeff mumbled as he shuffled towards her.
“My name is Sarah. How can we help you today?” She eyed the voucher in Jeff’s hand. “A voucher! Congratulations on being selected! Just hand that over, along with some ID, and I’ll take care of everything for you, OK?”
“Thanks.” He gave her the voucher and fished out his driver’s license. “Will this work?”
“Yup, that’ll do!” She typed some more, then placed a hand on his, “Don’t worry about a thing, hon. Everything will be alright.”
“Is…is it going to hurt?”
“We will need to take some blood, so unfortunately you will feel some discomfort.” Sarah patted his hand. “But no more than that! Now please go down the hall to my left, and take a seat in the waiting room, OK?”
Jeff nodded and proceeded down the hall. The voucher worked! I can’t believe this is really happening! He swallowed his excitement as he entered the waiting room at the end of the hallway. More important-looking people were sitting in comfortable leather-lined seats, waiting to be called into one of several examination rooms.
As he took his seat, he overheard a terse conversation between an impatient man and a nurse. “I have been waiting for an hour! I was told that my formulations were ready yesterday!”
The nurse smiled apologetically, “I’m sorry about the wait, sir. We performed a final quality control test and we found that the formulations weren’t fit for injection. This happens rarely, and I am sorry to have wasted your time. But at Anticine, we’d prefer not to give our clients a new allergy when we’re trying to remove one.”
The man grumbled and checked his tablet, “Let’s reschedule to next Wednesday.”
“Of course, sir.” She watched the man leave before settling her eyes on Jeff. “Mr. Williams? Jeffrey Williams?”
Jeff nodded, jumping up from his seat. The nurse beckoned him into an examination room and closed the door behind them.
“Nice to meet you, Mr. Williams. My name is Karen, and I’ll be walking you through the process today. It says here that this is your first time at Anticine Incorporated, so I need to give you the introductory spiel. Sorry if I sound like a commercial.”
She cleared her throat and went on autopilot, “Here at Anticine Incorporated, we take in patients and edit their immune system to rid their body of disease. It is a natural process, where we add or subtract antibodies from the patient’s immune system, antagonize or tolerize substances, and then let the body heal itself in whatever manner it sees fit. We pride ourselves on the high quality of our work, and on our vast capabilities to alter the immune system in a minimally-invasive way. All it takes is a couple of injections. Please call today to book an appointment.” Her eyes refocused on Jeff. “Sorry, that last part actually was from a commercial. Anyway, do you have any questions?”
“You’re… you can remove my diabetes, right?” Tension knotted inside as he waited for her answer. He felt the ghostly sting of thousands of past insulin needles poking into his gut before Karen merely smiled and nodded.
“Well, it says here: Type 1 Diabetes, auto-antibodies present.” She patted his hand, “Let’s remove those bad antibodies first, shall we?”
Jeff nodded, “So… you’re going to filter my blood?”
Karen smiled again, “No, but I will be taking a sample of your blood, and a bit of your bone marrow as well. First, we’re going to identify exactly which of your antibodies are targeting your insulin-secreting beta cells in your pancreas. Then, we’ll look at your bone marrow and find the B cells that produce those specific antibodies, and then come up with a formulation that eliminates those cells!”
“How are you going to do that?”
“We have an artificially intelligent, machine learning protocol that uses the Anticine Database of Antibody Structures to predict and solve the structure of both the bad antibody, and the membrane of the B cell that made these bad antibodies. Then, we’ll generate our own antibody that targets and destroys this bad B cell! Then no more bad antibodies!”
“What?” Jeff asked incredulously.
Karen pursed her lips in thought. “Think of it this way. There’s a sidewalk outside with still-wet concrete. If I step in it, it’ll have my shoeprint! My shoe will also get stuck in the sidewalk and ruin its aesthetics! What we’re doing is taking my shoes, looking at its size, shape, age, serial number, and purchase date. Then we’re going through the city records until they find me and get me to stop stepping in wet concrete! Does that help clear things up?”
Jeff scratched his head. “The shoe is the antibody?”
“Yes!” Karen beamed, “If you would like to get started, here are the forms that you need to sign. I’ll go prepare the necessary equipment.” A small parcel of forms suddenly appeared in his lap.
“I’ll be right back!”
She was gone in a flash, leaving Jeff staring at the packet before him. It sounded like magic to him. They were going to figure out what the troublemaker antibodies looked like, and from that, figure out which of his immune cells were making them? Then make their own antibody to remove those immune cells? He picked up a nearby pen and searched through the papers. They were definitely written in English, but most of it was unintelligible.
Jeff finally found the line that awaited his signature. I just have to sign this, and my diabetes will be gone? He thought about all those times when his insulin alarm had gone off embarrassingly in front of his boss and his coworkers. He thought about all those needles that he jabbed into his gut every time those alarms went off. The sharp pain, followed by the blood rushing to his face as he blushed with shame and humiliation. If he gave into the shame, he’d suffer the effects of unchecked diabetes: fatigue, blindness, brain swelling, coma, and worse. He thought about the insulin shot that awaited him this afternoon, and all the others that followed in the days and years
to come.
He signed the forms.
Jeff placed the packet on the bedside table, and climbed into the bed. As he waited for the nurse to return, he noticed that the TV hanging in the corner was showing a special news report. A smartly-dressed news anchor gesticulated dramatically. “We just heard the opening remarks in the lawsuit against Anticine Incorporated! Pollux Pharmaceuticals, along with several special interest groups, are alleging that Anticine Incorporated is violating laws by patenting naturally-occurring biological information and illegally profiting off of their patients’ antibodies!” The scene switched to a man dressed in a white lab coat as the news anchor continued, “I have Dr. Simmons from Anticine Incorporated here to give us the company’s perspective.”
“Thank you for having me! First, let me clear up some misinformation that Pollux Pharmaceuticals has been spreading. They’ve been losing market share since Anticine’s vaccines are so effective at stopping infectious diseases in their tracks! Anticine does this by using our neural network, along with our Antibody Structures Database, to quickly produce antibodies using vaccines, and produce vaccines from antibodies. Although this database is built from patient information, we use this information to generate new antibodies, and never just mass-produce someone’s antibodies. It is no different from genetically engineering a new plant using DNA information from other organisms.”
“And what about the epidemic occurring in southern Europe? Many special interest groups have alleged that the rise of enhanced HIV is directly caused by Anticine’s manipulations with the human immune system!”
Dr. Simmons adjusted his glasses, “I would hold off judgement until more data has come in. We have always used the immunological defenses of other organisms in medicine. But the penicillium mould still exists in the world, even though penicillin-resistant bacteria has made its immunological defenses obsolete. We don’t have any conclusive data that our ability to edit our own immunity will make the entire human immune system obsolete.”
The news anchor continued, “There has even been criticism about Anticine’s Voucher Program, in which anyone can purchase a voucher to be redeemed for free immunotherapy treatments. The purchaser could choose to give the voucher to someone they know, or allow Anticine to choose an applicant. There have been reports of patients refusing chemotherapy and gambling on the chance of receiving a voucher in the mail!”
“That is certainly unfortunate, but no one can deny the fact that thousands of people have already been cured of their chronic conditions and diseases through the voucher program. These people would otherwise have been unable to afford such personalized therapies.” Dr. Simmons straightened his lab coat. “They were healed by the compassion of human beings who are in a position to help their fellow man. I think this altruism is a wonderful thing, and something that shouldn’t be disparaged.”
That’s why I’m here. Jeff thought about the cardboard coupon that had appeared in the mail yesterday. There had been a small message on it from the donor.
Whoever you are, I hope this voucher eases your burdens and brings you relief.
Joshua Edwards
He had no idea who Joshua Edwards is, and would probably never get to thank him.
The door swung open and Karen swept back into the room, holding a tray filled with tubes, containers, and a few needles. “I’m back!” She announced brightly. “Have you signed the forms?”
“Yes.” Jeff nodded. He winced at the sight of the needles. His long history of insulin jabs had not dulled his wariness towards sharp metal objects.
Karen flipped through the authorization packet, “Everything looks in order. Are you ready to begin? I’ve got local anesthetics to help dull the needle pokes a touch.”
Jeff gritted his teeth. Another couple of needles, and then no more! That, and the diabetes is a pain as well. He flashed a nervous smile. “I’m ready. Please remove my diabetes.”
As Karen extracted what Anticine Incorporated needed, Jeff’s thoughts retreated inwards. Mom will be so happy when I tell her about this. Dave and rest of the crew won’t believe I got an Anticine Voucher in the mail. Hopefully the receptionist gives it back when I leave. Gotta show boss why I gave such short notice about taking the day off. I think he’ll understand.
Karen paused, “Everything ok there?”
“Just thinking about how lucky I am.” Jeff replied quietly, wincing as a needle entered his arm, “I… never would have been able to afford this treatment.”
She smiled, “Well, I’m glad you are here and getting treated. It makes me feel like I’m making a difference when I’m removing diabetes from someone in need, rather than a pollen allergy from another rich bigwig. Anyways, I’m all done here.”
“Already? I didn’t even feel anything.” He checked her tray, and sure enough, the tubes were filled with his blood and some other liquids.
“Well, you’re not cured yet, if that’s what you mean. Make an appointment in 2 weeks, and then we’ll be able to remove your pesky auto-antibodies then.” Karen opened the door and waved Jeff through, “Oh, and one last thing I forgot to mention.”
Another packet materialized in Karen’s hands, “Anticine’s ability to edit immune systems relies on its antibody database, and one of the ways that we build this database is by identifying and adding our patients’ antibody profiles. With more antibodies identified, our machine learning software can generate accurate structure solutions, faster.” She fluffed the packet in her hands.
“Anticine’s ability to quickly synthesize vaccines for infectious diseases also relies on this database. There are 8 billion people on this planet, and everyone’s been exposed to different pathogens and unknowingly fought them off. There are many hidden immunities in all of our bodies, just waiting to be discovered. We can take your antibodies, figure out their structures and generate vaccines that would be useful in other parts of the world.”
She looked into his eyes hopefully. “But we don’t do this without the patient’s express consent. So, Mr. Williams, will you let us add your antibody profile into our database, and help us cure other people like you, in the future?”
The TV program flashed into his mind, along with images of the protesters outside. They were so angry about a corporation profiting off the antibody information from regular people like him.
But Anticine Incorporated wasn’t just saving lives, it was also improving the quality of those lives by removing chronic, debilitating diseases. Jeff doubted that he could ever make enough money to buy a voucher for anyone, and if there was even a chance that his antibody profile could give someone else the feeling of freedom that he felt now, there was no other answer to Karen’s question.
“Yes. Add me to the database.”

THE BODY

by Courtney Hilden

Sometimes it becomes clear when a kin group is hoarding too much and has taken away from the larger community. When that community decides to take action, my team and I get called in.
The job, usually: go into the residence that the kin group has already been evacuated out of, go through the residence’s things, catalog them, allow the Council, separate from the community, to make a decision about the belongings, and then package them as the community sees fit.
But there was this time I was called out to Swan’s Way, located in the Aldebaran system, for a job, and although it looked like a standard job on the outset, it turned out not to be.
Swan’s Way used to be an oasis, but after some poor management decisions four hundred years ago, it’s a dry, though not humid, desert. There’s not much there anymore, just farmers maintaining and harvesting energy from the solar panels. Everyone jokes that Swan’s Way has more panels than people, and that’s always been my experience too. The family we were investigating had been convicted of excess, and so that means they’d probably have quite a few things that needed cataloging and moving.
And it was, as expected, a fairly nice house. It had tan walls and dark wood furniture. There were tall ceilings and large windows.
I was actually in the other room when Canis found it, sweeping out glass that had been shattered on the floor.
“Mirfak, come in here. You’re going to want to see this,” Canis said. I had heard that a thousand times before, so I didn’t hurry. I figured it was going to be some ridiculous art that indicated just how guilty this family was of excess.
Instead, it was a person. Or it looked like a person, at least in the shadow. I came closer. It wasn’t quite a person. Sure, they were the typical morning gray color, with a normal set of breathing and eating holes on their torso, but the head was unmistakably not a real head, but a mechanical one. It was crude, with a corner smashed in.
It smelled terrible. Its breathing holes were crusted over and its food hole had a great smear of orange over it.
Eyes had been drawn on its mechanical head, but they obviously had no function other than to make the creature less horrifying.
I suspect Canis knew what I was thinking. “The eyes don’t really fulfill their function, do they?”

I brought the body back to the Procyon system, where we happen to have a headquarters. It’s a warehouse essentially, since sometimes we have to spread people’s possessions out on the floor, sometimes we have to photograph them. Sometimes we put them in storage, but the central room is mostly bare unless we are working a case. Regardless of our active case status, there’s always a few desks we move around the room as needed, with some computers set up to handle any tech we get, and our work tablets, which we use for correspondence and creating lists. I called in Crieff, an old friend of mine who has done some healing work. I watched him as he
silently did a check on the body’s outside.
“Someone is very clever,” Crieff said. “This body is indeed someone’s real body, or it was, once. Can’t be sure.”
“Who’s?”
He shook his head. “I don’t know. This body was never marked like we do with all babies.”
“How did they create this?”
“The mind is the seat of consciousness, personality, self, identity. But the body can go on without the mind, if fed.” He turned to Canis. “It has been starving well before you found it. Please go find it some food.” Canis happily left the room, her eyes staying on the body the entire time.
“Considering this family was convicted of excess, I am assuming this was a servant,” I said. “Who would allow their body to be removed from their mind?”
“I don’t believe it was voluntary. Did you carry it here?” he asked.
“Yes.”
“You could have given it directions and it would have walked here on its own.”

I was hoping Crieff would have some thoughts on the body’s identity, some trick of getting it to talk, because it didn’t have the kind of mouth with vocal cords attached, but it didn’t initially, so I had to ask to see the file on the kin group, something I have never, in all my long years of cleaning, have ever asked to see.
I looked through the Enright kin’s paperwork, and it was clear how they had been convicted, just looking at the discrepancies in their financial filings. But at the back of the file was a set of pictures, and my stomach dropped when I saw them. All of them had the same morning gray skin.
Canis looked over my shoulder. “So they hadn’t kidnapped anyone?”
“Almost certainly not. There is no need to inquire to surrounding communities if someone had gone missing. No one was missing this person.”
“But there’s no one in these pictures with that exact pattern of breathing and eating holes.”
“I think they were wise enough not to let the servant take pictures.”
“Or the servant was taking the picture.”

Council was not amused. “Are you telling us that the kin in question had killed someone via decapitation, then stuck a mechanical head on it?” one of them asked me.
     I had tinkered with it in the days in between, trying to be gentle. “Possibly,” I said. I removed the front metal plate on the head. There were a mess of wires inside, and a motherboard. “I think it was a servant. It’s programmed to do certain things in a pattern over time. It is programmed to cook five times a day, clean once a week, and otherwise lay in a certain position in the room it was found in. But someone tried to reprogram it recently, the last time it was accessed, and it was a bad job, because I don’t think it could move after that.”
One of the other councilors raised her eyebrow. “A certain position?”
“I think it was possibly being used for breeding, or at least was intended that way. I cannot be certain it was actually used like that before your good council had the kin evacuated.”
“What do we do with it now?”
“I was of the mind that we should have the mechanical head removed, then leave it to die naturally of starvation. Then I thought perhaps a bayonet would be kinder, quicker. But I am increasingly of the mind that we should have it programmed for optimal self regard, then allow it to live the last of its days here.”
“There’s been debate about optimal self regard,” the first councilor commented.
“Nothing rivaling the self regard of the kin group from which is originated from,” I said.

The Council took time with their decision, and in the meanwhile, I found it unnerving. Canis wiped the software, at the behest of the Council, which at decided that was the bare minimum that should be done. After that, we had left it in the office, sitting in a chair in the corner under the control panel, and Canis and I worked as normally for the rest of the day. The rest of the Enright things had to be organized. We got some of it done, but there were still piles of clothes, a few electric tablets, furniture of various sizes, an extravagant collection of artwork, including one I quite liked of a crane, and an old school 3D printer.
After Canis went home, I cleaned up. I went to turn off the lights at the control panel, and there the servant was, staring back at me. There was something not right about this, but I couldn’t quite figure out what.

     When we came back the next day, both of us stopped when we saw everything. All the clothes was folded, and in piles. The electric tablets, which had collected dust, had been cleaned. I picked up one of them, plugged it into our computer. “It’s been wiped clean. Did you get to that yesterday?”
Canis looked back over at me. “You didn’t do it after I left?”
There was a clanging sound, and we both jumped. We turned to see the servant, also clearly having just jumped itself.
     “But the programming was wiped clean,” I said, feeling deeply stupid. I turned to Canis. “Didn’t you…?”
     “I did.”
It titled its neck at us, with those eyes that never changed. It slowly raised its hands.
“It’s okay, it’s okay, everything’s fine,” I said, raising my hands too. Canis followed suit.
“Can you—” then I realized how stupid my question was. There was no way to answer. “Give it one of our tablets and a stylus,” I said to Canis.
     It slowly reached down to the table and picked up a stylus, keeping its other hand up.
“Well, that answers one question,” Canis said.
It wrote, though its hand shook. It held the tablet up. It read I am sorry for scaring you .

Crieff came out again. We left him in the office, alone with the servant, while we waited outside, sitting on the bench next to the front door. It was a nice enough day, but I think both our minds were elsewhere. When he came out the door, we both stood quickly.
“It’s fine,” he said. “It can hear you.”
“But how is it moving?” I asked.
“The stomach has a bundle of nerves, a secondary brain. When the body lost its first mind, it was able to move functioning to its secondary brain. Probably would have never happened if they hadn’t sustained the body in other ways.”
“But then why use the fake head and the programming?” Canis asked.
“I think the programming was to suppress the secondary brain making its own choices.”

The Council didn’t respond immediately when we sent a message about this development.
“The Council might take awhile,” I said to Canis as we worked at our desks. “Without a primary brain, I’m not sure if it even be a self, since the seat of itself is gone.”
“It’ll never have its identity again, whatever it was in its real, first life.”
“Perhaps that’s for the best.” We both looked over at it. It was sitting in a chair. It did the head tilt again. It slowly raised its arms again and took the stylus next to it. Canis handed it a tablet.
We watched it jerkily write again. No life .
“Do you mean—” Canis stopped herself.
It began to write as quickly as possible. It had to stop, slowly clean whatever it initially wrote, and try again. Enright ?
Canis and I exchanged another look. Thank God it couldn’t see.
“You kin,” I said. “Have refused to communicate with us. Possibly for legal reasons.”
It straightened suddenly.
“Your kin were convicted of excess,” Canis said. “What do you—?”
“It began to furiously write something. It held it up. Neither of us could read it. “I’m sorry,” Canis said. “What are you trying to say?”
Another attempt, with shaking hands. Auteuil Illiers .
I usually never use my work tablet for something like this, but I searched that name in the database. Canis also busied herself with her tablet.
The Auteuil clan had lived in Swan’s Way. I opened one of the files in the database and saw an old murder investigation from years ago. It had been a small group, but they had all died.
“I’m sorry,” I said. Before I could say any more, Canis turned her tablet to me. It was a picture of the Auteuil clan. In the background, there was an old 3D printer and a set of extravagant paintings.
I flipped through the murder file. I stopped at an image of Illiers. He was a painter. He was midway through a crane’s wing. I turned to the painting, propped up against the opposite wall. I turned my tablet around so Canis could see it.
I took a deep breath. “Our records indicate that Auteuil Illiers died four years ago.”
Its shoulders slumped. It stopped moving long enough that I thought perhaps it had turned off or had a circuit overload and couldn’t anymore. And then it curled up into a ball, still sitting in its chair, hugging itself.

KEEPING HOPE ALIVE

by Divya Raman

If it were not for hopes, the heart would break. I trace the cursive letters of these words embroidered on the edge of the blanket draped over my arm. I remember hearing those words for as long as I have lived. For the first time, as my great grandmother whispered it to my mother when I was born and they discovered I had a heart defect; from my mother, each time I came out of a surgery that tried to fix my failing heart; and I heard it like a refrain in my mind as I saw the grim faces of my doctors as they studied the heart of my unborn daughter on their screens.
My great grandmother lost her daughter in 1949, after a traumatic birth at home. She never knew what ailed her baby; all that she knew was that less than a day in this world, the little girl she had wanted all her life turned blue and stopped breathing. She had all her other children in the hospital after that, surrounding herself with doctors and nurses who she revered as if they were messengers from God. But she never got over the loss of her baby girl; never forgave herself for not having noticed her baby’s color or breath. For every child born into our family after that, she made it a point to be there, keeping a keen eye on the newborns through their first weeks. It was she who noticed when I started to pale a few hours after I was born; it was she who rushed out and called the staff in a firm tone; it was she who watched the screens and asked the doctors questions my mother was too overwhelmed to think of; it was she who had this blanket made for me when I was just a few months old. I wish she was here now, telling me to keep my hope alive.
I was born with a hypoplastic heart. When I was little I used to call it a plastic heart , wondering if my Princess Barbie had one of those inside her plastic chest. Later a doctor told me that left side of my heart was not as big as it should be, so the right side of my heart was trying to do more, and was getting tired. It would take a series of three surgeries within my first five years to help my heart get better. My first surgery was when I was a week old, and it was intended to get me through to 6 months. At 6 months, I had another surgery to reduce the load on the right side of my heart. I once saw of picture of me taken on my first birthday and I looked small and blue;
there were tubes connected to me. You wouldn’t have known I was a year old if it wasn’t for a large balloon tied to my crib. I had my third surgery when I was 3 years old. It was the last of the series, and the doctors knew that my only option after that was a heart transplant.
I had a quiet childhood; I was on medications and a feeding tube and my parents didn’t take me out very much for fear that I would fall sick. They finally enrolled me in school, but I barely made it through a month of Kindergarten before my heart started failing again. I was put on a heart transplant list and taken out of school. My mother and I would spend the days under the tent canopy on my bed, snuggled in blankets reading from a pile of books. Sometimes she would fall asleep and I would quietly take her phone and play a game. I remember the day I pressed something and opened an article about transplants. I couldn’t read all the words, but one line
was written in big text and I sounded my way through it: “58 children died while waiting for a new heart”. My heart sank, and I turned off the phone quickly, worried that my mother would see what I was looking at.
My mother got a call about a heart for me just before my seventh birthday. Within hours we were on our way to the hospital, ready for a surgery that was going to happen at midnight. My doctor came in and spoke to my mom. He then turned to me and told me that I would fall asleep and when I woke up there would be another heart in me, and I would start to feel better.
“Where did you get the heart from?” I asked.
The doctor paused and looked at my mother. Slowly he said, “Your new heart used to belong to a little boy who died yesterday because he was in an accident.”
All I could think about was that for me to live, a little boy had to die. I nodded slowly. “Tell his mom I’ll keep his heart safe forever.” And I have done exactly that for over 20 years now.
When I was in high school, I learned that my heart condition was genetic; that my great grandmother’s daughter likely died undiagnosed from the same congenital heart defect I had. The geneticist suggested that there was a chance that if I had children, I would pass along this trait, resulting in my child having the same congenital heart defect. Even with this knowledge, I knew I wanted to have children of my own. Armed with hope and science, I conceived my first child and opted for all the extra scans to monitor her growth. At 20 weeks, they started to see some abnormalities in my daughter’s heart and found the same genetic trait in her as I had. I
knew that we were about to embark on another long journey, and I was determined to do all that I could to make it a little easier for my little girl.
I found a famous surgeon at a heart center on the other side of the country and asked her for all my options. As she started naming series of surgeries and transplant options, I stopped her. “Tell me the about something that didn’t exist 30 years ago”, I said. Little did I know that what she would tell me next would completely change my daughter’s life.
She described a new artificial heart that was still in clinical studies; it was made from a bioabsorbable material that would let my daughter’s cells grow onto the surface, making it her cells and her tissue over time. They would be able to make one that was the right fit for her little body when she was born, and over time it would grow with her, minimizing the need for multiple surgeries over her first few years. It had a small electrical component that would make it beat to circulate blood, and a battery that we could charge wirelessly. “That’s it!” I said, “That sounds perfect.” I was elated; my daughter’s life would be different. She wouldn’t spend her first few years with tubes and surgeries; she wouldn’t look blue on her first birthday; she would go to school; no other child would need to die to allow her to live.
The surgeon continued, “The lab results show that your daughter has the same genetic disorder that you and your great grandmother carried. We can also start some gene therapy in utero that will change the mutation as she is developing. She will need to continue to have a few treatments after she is born, but the research shows that gene therapy can be very effective if we start it earlier in gestation. You will need to plan to come in for those appointments and we’ll also need to get you in the center for some imaging over the remainder of your pregnancy.”
I was surprised. “Gene therapy before she’s born? Is that safe? And why do I need imaging?”
The surgeon nodded. “Gene therapy is safe to deliver through the amniotic fluid. We’ll monitor how effective it is once she is born, but we’ve had a few cases where the child needed very few additional treatments because we started so early in the pregnancy. The imaging is to allow us to prepare your daughter’s implant before she is born. Our scanners are strong enough to safely see all of your little girl’s heart and vessels as they develop. We’ll start to take some pictures so we know exactly what shape and size her new heart needs to be, and we can have it ready for her once she is born.” She paused and looked me in the eyes. “We don’t know how stable her heart will be when she is full-term; we need to be ready to act at any time. We will monitor you closely for your final weeks. If everything looks normal, you can have a regular delivery and spend a few hours with your daughter before we start the surgery. However, if there is any sign of distress, I recommend that we complete an emergency C-section and get your daughter into surgery immediately.”
I gripped the side of the chair I was sitting on. “Will she be okay to have the surgery so soon after she’s born?”
The surgeon didn’t waver. “It is a complicated surgery, and as with a transplant, there are a lot of factors to do with the body starting to properly absorb the material. All the data on this product has been in adults, so your child will be the first to experience this procedure. The results for adults look very promising, and I believe it will be equally beneficial for a child. But there is always a risk. We will monitor your daughter closely after surgery, and will need to keep
everything in check for the first year or so.”
For a moment, a dark cloud of doubt blinded me. Was gene therapy the right thing to do?
Changing my daughter’s genes before she was born sounded like playing God. Would changing her genes change the fact that she was my daughter; my flesh and blood? Would I be cutting off her ties back to my great grandmother? Was it worth it to give up a piece of family heritage to know that she could have a family and never worry about this for her child?
Was subjecting my daughter to a new heart implant the right thing to do? Should I instead let my child go through the same experience I had, and feel safer in knowing that it may extend the time I have with her? Should I hope for the untimely death of some other child in order to gain a transplant heart and life for my own? If I went into an emergency C-section and then lost my child to surgery, would all of this have been for aught? Would my heart ever mend from that sorrow? If all I got was a few hours with my little baby, would that be enough time to make memories to last me the rest of my lifetime? I felt as if I was drowning, but then heard my great
grandmother’s voice: If it were not for hopes… I took a deep breath and faced the surgeon head on. “I understand; we’re going to fight for this. I’m ready to show my daughter how.”
My daughter, Zita, my little hope, was born in an emergency C-section and then whisked away to the OR where she received her new artificial heart, which had been waiting for her, ready to become part of her and to give her a new life. I finally got to hold her 2 days after she was born, but it was worth the wait. I traced her chest incision and hoped that it would be the only scar she would bear in her life. I marveled in her pink coloring and could not stop the tears of joy as she
held onto my finger for the first time. We have been back to the hospital many times over her first year, taking all the extra precautions to make sure that her body is absorbing the tissue and that her heart is working as it should. She has also completed two additional gene therapy treatments to remove the mutation that my great grandmother passed down.
As I wait in the lounge for the nurse to bring her back from her final set of scans, I know that I will miss the safety of this building; it’s a place where I lived my scariest nightmare, but also realized my biggest dream. I see the cardiologist walking towards me and I stand, immediately worried.
He smiles and gestures for me to sit. “Things are looking good with Zita. You can take her home, and we can start to see her every 6 months, unless you need to bring her in sooner.”
I swallow, not knowing how to put my biggest fear into words. “How will I know if something is wrong?” I ask.
The cardiologist nods and pulls out a phone. “Just call me; I can see all of the information from her heart here.” He opens a screen that has Zita’s name at the top. I watch the dancing waves showing the beating of my daughter’s heart. I finally smile and realize that I can feel safe even outside these walls.
I know hope is only one part of our story. Science and the human drive to forge new paths are the bigger parts. Hope kept my mother’s heart from breaking, and now it will keep mine intact. Science kept me alive, and it has now given my daughter a whole new chance at living.

Thanks to everyone and we’re already looking forward to hosting next year’s Medgadget Sci-Fi Writing Contest!

Bloodstream draw startup Drawbridge Health enters proper collaboration with wellness business

Drawbridge Health bloodstream testing device

Drawbridge Health, a GE Ventures spinoff that created a device to attract bloodstream without discomfort and chemically stabilizes it for transport, has decided to a proper collaboration with Thorne Research, a overall health business that promises to use Drawbridge Health’s technology to aid its personalized wellness programs.

It marks the very first partnership since Drawbridge’s launch recently. The organization is preparing for numerous studies with the aim of securing  510(k) clearance in the U.S. Fda for that device.

Drawbridge created a handheld device that’s put on top of the arm. Two buttons are pressed, pricking your skin, establishing a couple of drops of bloodstream that flow in to the device’s chamber and onto a strip of paper, which functions to stabilize the bloodstream. The paper eliminates the requirement for refrigeration and extends the sample’s shelf existence.

Thorne Research developed bloodstream biomarker tests. It uses the outcomes and analytical software to assist develop personalized plans for customers’ diet, exercise and supplements they ought to take. Its subsidiary WellnessFX developed an application to assist consumers schedule bloodstream, genetic and microbiome testing which help them comprehend the data through phone consultations with doctors to look at biomarkers that measure cardiovascular, metabolic, hormonal and dietary health problems.

Included in the deal, Thorne Research can get exclusive legal rights to distribute and commercialize future Drawbridge Health products inside the U.S. overall health industry. As a swap, Thorne Research invested millions in Drawbridge Health insurance and Thorne Research Chief executive officer Paul Jacobson will join the board of company directors for Drawbridge, this news release noted.

Wellness is among the groups Drawbridge Health Chief executive officer Lee McCracken identified for his business within an interview recently.

“There’s a fascinating subset from the market: niche diagnostics, firms that are addressing reproductive health, chronic disease management, dna testing, wellness,” stated McCracken. “They’re already running samples, searching for any better experience that’s simpler for any patient or consumer of diagnostics.”

MedCity ENGAGE, October 23-24 in North Park, concentrates on the most recent strategies and innovations to boost patient engagement, care delivery and company wellness. Use code MCNTAG in order to save $50.

Slip in hospital safety rating score spurs doctor to file a lawsuit Leapfrog Group

For 2 years, Saint Anthony Hospital here has celebrated its top-rated “A” grade in the national Leapfrog Group that evaluates hospital safety records. However this fall, when executives opened up a preview of the score, they were given an unwelcome surprise: a “C.”

Hospitals place their ratings seriously, despite hospital industry experts’ skepticism regarding their scientific methodology and studies showing that scores might not have an enormous affect on patient behavior. Inside a highly competitive market, nobody wants to become a “C”-rated safety hospital any greater than a “C”-rated restaurant for cleanliness.

So, a healthcare facility didn’t take its new grade sitting lower. It sued the ratings group for attorney, alleging the grade took it’s origin from data that Leapfrog understood to become inaccurate.

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“If Leapfrog publishes a ‘C’ grade for Saint Anthony included in its Fall 2017 Hospital Survey Grades, it’ll erase many years of enhancements in the hospital and irreparably degrade the general public thought of a healthcare facility,” based on the complaint, that was filed within the Circuit Court of Prepare County, Ill. “Saint Anthony competes along with other hospitals within the immediate area, including one lower the road, and probably the most important ways Saint Anthony lately has had the ability to distinguish is our prime safety grades it receives from Leapfrog.”

Inside a response filed towards the court on Tuesday, Leapfrog known as Saint Anthony’s suit an “eleventh hour gambit to show back the time on the disappointing safety grade located in part around the data that [a healthcare facility] itself provided and licensed, and which Leapfrog simply utilized in compliance using its lengthy-established processes.”

Leapfrog is among numerous organizations, including U.S. News and World Report, Healthgrades and Consumer Reports, that score hospitals according to whether or not they meet certain quality measures. Located in Washington, D.C., Leapfrog’s scores are a mix of 27 measures of quality from government data as well as an independent survey to judge such things as infections, deaths among surgical patients and just how well doctors communicate.

About 50 % of hospitals take part in Leapfrog’s survey others are evaluated based only on openly available data. Leapfrog’s mission would be to help hospitals improve in weak areas and also to give patients helpful information.

Hospitals are quick to tout a’s and b’s on advertising and banners.

Saint Anthony’s complaint seems is the very first time a medical facility has sued a rating agency more than a contested grade. However in a period when hospitals are brands and people are customers wishing to create rational purchases for care, such grades and rating systems will probably face more scrutiny and new pushback.

“In highly competitive markets, hospitals will probably see poor grades like a challenge, and i believe most be enticed to file a lawsuit the rating agencies,” stated Ashish Jha, a professor in the Harvard T.H. Chan School of Public Health.

Jha, who had been on the committee that helped set standards when Leapfrog started, stated he was heartened that hospitals are reacting to data, regardless of the impetus. “If they’re likely to use that as motivation to obtain better, that’s perfect,” he stated. “As someone, you do not care why a medical facility is purchasing safety, you simply care that they’re.”

It’s unclear how much grades influence patient decisions. A Pew Research Center survey from 2012, for instance, discovered that only 14 % of online users consulted online rankings or reviews of hospitals or medical facilities.

But Saint Anthony hospital executives insist Leapfrog’s score comes with an enormous impact on their main point here. “We have experienced, for much better or worse, that individuals are having to pay a lot of attention — not just our patients but additionally our stakeholders, vendors and politicians,” said Dr. Eden Takhsh, the hospital’s chief quality officer. Such scores also have influenced them to pay attention to improving certain quality metrics, for example rates of sepsis and central line infections.

Leapfrog’s scores are plastered across every newspaper around, he stated. According to their past “A” grades, Takhsh stated, Saint Anthony continues to be contacted by the College of Chicago and Northwestern, two much bigger teaching hospitals in Chicago, to create partnerships in pediatrics and neurology. Both hospitals provided to send their physicians to Saint Anthony to supply subspecialty care, which may supply the small community hospital with increased patients and prestige.

A “C” grade could threaten individuals partnerships. “These organizations shouldn’t work with someone with poor since it hurts them,” stated Takhsh.

Dr. Karl Bilimoria, a professor at Northwestern College in Chicago, stated it’s unclear whether ratings should have a lot influence. “These ratings systems are overall of low quality,” he stated. “Most of these use data which are generated for billing, so they’re not particularly accurate.”

Major ratings systems “frequently conflict,” simply because they use different criteria, he stated: “A hospital could be rated best on one of these and become rated poorly on another.” Saint Anthony, for instance, was rated three from five stars on Medicare’s Hospital Compare website throughout the same period it received an “A” from Leapfrog. A healthcare facility wasn’t incorporated in U.S. News and World Report’s top 22 hospitals in Chicago.

Hospitals can pick to market the rating which makes them look best. Patients might be astounded by a hospital’s “Top Hospital” banner but never begin to see the lower scores.

Some ratings groups charge for that display. Leapfrog charges $5,500-$17,600 for any hospital to make use of its emblem in advertising, with respect to the hospital’s size. Others, for example U.S. News and World Report’s “Best Hospitals” program, also levies a charge, but Consumer Reports doesn’t.

The ratings systems differ broadly about how they compile their scores, and a few tend to be more centered on the caliber of care than the others. “Leapfrog is the greatest and also the only openly reported rating focused solely on safety. It had been produced by top experts and uses the most effective openly available data,” stated Leapfrog Chief executive officer and President Leah Binder. “Our comments are scrupulous.”

Saint Anthony’s suit relies upon the issue of methods its physicians order medications, which Saint Anthony believes was the main reason behind their lower grade. The grade was wrong, a healthcare facility claims, since it is according to an inaccurate assessment that physicians prescribed medications digitally only 50 to 74 percent of times. Saint Anthony maintains that it is physicians actually prescribe digitally 95 % of times. A healthcare facility contacted Leapfrog several occasions to repair the mistake but Leapfrog declined, based on the suit.

Leapfrog contends that Saint Anthony didn’t contact it inside the appropriate bi weekly period of time, based on Leapfrog’s defense document.

Leapfrog has removed Saint Anthony’s grade for the time being, and can likely repost it pending further analysis, noting the electronic ordering issue was unlikely to completely explain the “C” grade.  “There’s clearly some inadequate and sloppy reporting out of this hospital,” stated Binder.

Dr. Karen Joynt Maddox, a helper professor in the Washington College Med school in St. Louis, stated the dispute underlines the weaknesses from the ratings information open to patients. “This whole field is much behind where it must be,” especially because of the proliferation of “consumer-driven” high-deductible plans, she stated, adding: “there’s vacuum pressure when it comes to consumer-friendly information.”

Kaiser Health News is a nonprofit news service covering health problems. It’s an editorially independent program from the Kaiser Family Foundation that isn’t associated with Kaiser Permanente.

Photo: Mykola Velychko, Getty Images

Heart Pump Operated by Electric Cable Routed Through Mind


Left ventricular assist devices (LVADs), popularized including by Dick Cheney, have grown to be somewhat common previously couple of years. They augment the cardiac output, and in some cases they’ve considerably extended the lifespans of heart failure patients.

Managing LVADs could be a challenge, having a particular emphasis put on maintaining your area in which the cord comes from the body pristinely clean. Typically, the cord is undergone your skin around the abdomen, but keeping that area clean might be difficult if it is vulnerable to being wet or soiled. In the Osaka College Hospital in Japan, clinicians faced just this type of problem.

A heart failure patient with finish-stage kidney disease wanted with an LVAD implanted. Japan’s national health system doesn’t offer LVADs to patients who’ve another serious condition, for example kidney failure. Yet, the individual ended up getting an exemption in the situation, possibly since the doctors desired to try routing the cable therefore it comes from the mind. It was since the patient loves to absorb the tub, and raising the cable’s exit port over the tube was preferred.

The surgery effectively routed the ability cable with the neck and from the mind, roughly where bone performing assistive hearing devices are usually connected. The LVAD continues to be energized and also the patient securely discharged to visit home and soak away within the tub.

Osaka University…

Editors

At Medgadget, we set of the most recent medical technology news, interview leaders within the field, and file dispatches from medical occasions from around the globe.

3D Printing Helps you to Implant Dangerous Transcatheter Mitral Valves

Transcatheter aortic valve implantations are actually routine at numerous high-finish hospitals all over the world. Non-invasive mitral valve replacements, however, are much harder and vulnerable to publish-op complications, and they are still a rarity. Yet, 60% of patients over 75 have mitral valve disease, and it is a level bigger problem than aortic valves. We visited the Henry Ford Hospital in Detroit to discover a cutting-edge program where clinicians use 3D printing and computer simulations to assist install substitute mitral valves without getting to turn to open surgery.

The Middle for Structural Cardiovascular Disease at Henry Ford Hospital is headed by Dr. William O’Neill, a master within the field, who came back to Detroit carrying out a sting at College of Miami School Of Medicine. Dr. O’Neill and the team created a process and compiled the various tools and devices essential to pre-plan transcatheter mitral valve replacements (TMVR). They labored with Materialise, a 3D printer located in Plymouth, Michigan, so that you can consistently convert CT scans of hearts into computer simulations and 3D printed hearts that may be examined and manipulated to determine what valves to implant where to put them.

Though each one of the bits of this method, for example CT checking and 3D printing, aren’t uncommon, tying them together continues to be challenging. We spoken with Bryan Crutchfield, a VP and GM of Materialise’s United States operations, who described that converting CT scan data into 3D printer files is itself an elaborate process. To create helpful models, the organization developed software that cleans up many of the noise and physiological fragments, after which clinicians with the aid of Materialise’s specialists perform some manual computer try to define the ultimate model. These models will be printed immediately in the hospital and could be examined and evaluated for various valves. Once that’s done, the process turns into a lot simpler and could be performed with greater confidence, resulting in much improved clinical outcomes. And also the figures show this.

We spoken with Dr. Dee Dee Wang, a cardiologist who’s Director of Structural Heart Imaging at Henry Ford Hospital and Medical Director of 3D Printing at Henry Ford Innovation Institute concerning the challenges of mitral valve implantation and just how she overcomes these challenges using today’s technology. The mitral anatomy is much more complex compared to aortic one, requiring significantly more intending to make certain an implant is positioned properly and fits the patient’s anatomy. One of the most common complications of non-invasive mitral valve implantations remains output tract obstruction. This occurs once the new valve protrudes in to the ventricular output tract, creating one other issue altogether. Sometimes the valve embolizes since it detaches from its implant site and floats away, creating an urgent situation that may simply be worked with open heart surgery. Since patients receiving transcatheter mitral valves happen to be high-risk for open heart surgery, this really is clearly a vital problem.

Dr. Wang described to all of us that about 20% of TMVR procedures using conventional imaging and sizing result in left ventricle output tract (LVOT) obstructions, that are also hard to reverse and wish open heart surgery. CT scans don’t supply the intuitive depth perception required to size new valves properly and calcified regions are poorly defined, which makes it a lot more of a guessing game. During open mitral valve procedures surgeons really stick types of valves in to the anatomy to determine what will be a good fit, however this doesn’t seem possible inside a non-invasive procedure. Top quality 3D prints, however, reproduce this method making it clear to see the anatomy and different challenges of positioning a valve inside a difficult place without them protruding an excessive amount of in to the left ventricle output tract.

The printed models are within one millimeter precision from the patient’s own hearts and also have the necessary depth and handling to have an interventional cardiologist so that you can alter to determine what valve to insert where to deploy it. Dr. Wang appears proud the manufacturing and prototype approach that they’ve taken at Henry Ford for repairing hearts mirrors Detroit and it is auto industry. She’s developed quite an accumulation of 3D printed patient hearts, that is beginning to appear enjoy it may eventually be considered a museum collection. They are still helpful devices, as they possibly can be referred to when similar patient cases are available in.

Our trip to Henry Ford was exciting and academic so we were quite astounded by we’ve got the technology that’s used in challenging transcatheter mitral valve procedures.

Finally, here’s a relevant video story in regards to a 16 year-old with a number of heart disease which was helped by doctors by 3D printing his heart when preparing for that procedure:

Links: Materialise homepage and the company’s Products for Cardiologists and Cardiac Surgeons…

Related study in JACC: Cardiovascular Imaging: Predicting LVOT Obstruction After TMVR…

College of Minnesota Researchers Create a Better 3D-Printed Organ Model


3D-printed organ designs include proven lots of promise in medicine by supplying doctors having a tangible representation of the organ being studied. While these models are wonderful at mimicking the dimensions and exterior appearance of the biological counterparts, otherwise they’re typically not so helpful.

Researchers in the College of Minnesota have finally developed 3D-printed organ mixers are a little more functional. Furthermore they precisely replicate the look of a body organ, they also precisely mimic both exterior and internal physiological structures, mechanical qualities, and feel. It was accomplished by developing customized silicone-based inks that precisely match the mechanical qualities from the biological tissues being mimicked after which fabricating the organ models on custom-built 3D printers.

They also attached flexible, 3D-printed sensors towards the organ mixers measure pressure and pressure. This enables researchers and clinicians to see the results of compression tests and the use of sutures along with other surgical tools around the model, that could better train surgeons about how much pressure they are able to apply with no damage to tissues.

Researchers will also be investigating how you can print with multiple inks to produce more complicated organ models. Such models may even mimic the existence of a tumor or deformity, so surgeons can test different techniques for removing tumors or correcting physiological complications.

Check out a short video explaining the organ models:

Study in Advanced Materials Technologies: 3D Printed Organ Models with Physical Qualities of Tissue and Integrated Sensors…

Via: College of Minnesota…

(hat tip: MDO)

Scott Jung

Scott Jung (@scottjung) is really a Plastic Valley-based health and medical technology journalist and advocate. He is a guest cause of Intel’s iQ e-magazine and Rock Health’s corporate blog and it has provided live, on-site coverage from the Worldwide CES and Digital Health Summit, TEDMED, and Stanford Medicine X conference for Medgadget. Most lately, he’s been appearing on TWiT.tv’s The Brand New Screen Savers like a semi-regular health and medical technology correspondent. Scott holds a b -.Utes. degree in Biomedical Engineering in the College of Los Angeles. Scott is definitely searching for the following big factor in medical technology and digital health. Thinking about helping him transform lives? Make contact with him at http://scottjung.internet

Tissue Analytics expands from New England, establishes office in Might

Tissue Analytics wound monitoring platform

Wound monitoring technology startup Tissue Analytics has built an eight person office in Might, Kansas following its hire of former Cerner staffer there who setup work within his new role as v . p . of sales, based on a tale through the Might Business Journal.  It marks an expansion for the organization which formerly was resides in one office in Baltimore.

Captured Tissue Analytics became a member of Cerner’s Open Development Experience, which provides third-party developers the opportunity to build applications that can interface using its electronic health record systems. Tissue Analytics Chief executive officer Kevin Keenahan told the company journal that the opportunity to integrate straight into Cerner’s Electronic health record may help his business streamline installation in days.

In October, Tate Gilchrist, senior business developer of open platform services for Cerner, told the company journal it had about 22 commercial application developers partnering using its systems.

Captured Tissue Analytics inked an offer with Intermountain Healthcare in Salt Lake City to integrate the startups’s wound monitoring technology, moving that adopted a 16 week pilot of Tissue Analytics technology this past year.

Tissue Analytics has a smartphone application, which clinicians use to snap a photograph of the wound, after which, through some algorithms, data concerning the wound’s shape and color are recorded, kept in the cloud, and readily available for nurses and doctors to gain access to. Its approach is made to make workflows simpler and much more intuitive and is made to rival medtech titans such as Philips.

MedCity ENGAGE, October 23-24 in North Park, concentrates on the most recent strategies and innovations to boost patient engagement, care delivery and company wellness. Use code MCNTAG in order to save $50.

Myriad’s riskScore test for cancer of the breast risk adds another layer of precision

On Wednesday, day two 2017 Dallas Cancer Of The Breast Symposium, Myriad Genetics unveiled pivotal validation data meant for its new riskScore genetic test, made to evaluate a woman’s five-year and lifelong chance of developing cancer of the breast.

Used, it’s a follow-up test. The riskScore test is indicated for ladies having a genealogy of cancer of the breast that do not carry mutations most of the major genes, for example BRCA1/2. Rather, it appears in excess of 80 point mutations (SNPs) which have a far more complex relationship using the disease.

To know the product’s value, otherwise this could happen scenario:

A lady in her own late 30’s schedules a scheduled appointment together with her obstetrician/doctor. She’s concerned, since she’s growing older, about her chance of developing cancer of the breast. A number of her aunts and her paternal grandmother all developed the condition within their 60s and 70s, she informs the physician. Surely there is a genetic component?

The conventional plan of action would be to order a gene panel test to find out if the patient includes a mutation in a single of 11 genes recognized to directly impact cancer of the breast risk. However, for much better or worse, the individual tests negative its them. She goes home without any solutions.

Johnathan Lancaster, chief medical officer of Myriad Genetics, has witnessed this engage in many occasions before like a practicing primary health care provider/gyn physician.

“They’ve arrived at their physician having a strong genealogy but, 90 % of ladies for the reason that scenario test negative for that cancer of the breast genes,” Lancaster described inside a phone interview.

This is where riskScore is available in.

It dives much deeper into so-known as ‘polygenic’ traits multiple genetic variants that could increase risk in the existence of other mutations or lifestyle factors. Because of this, the outcomes are combined with well-established Tyrer-Cuzick model, which considers person-specific variables (like the utilization of hormone substitute therapy), alongside genealogy.

Come up with, riskScore and also the Tyrer-Cuzick model generate a combined residual risk score (cRRS) specific to every patient. Within the validation study of just one,617 women with no 11 major cancer of the breast genes (990 women with cancer of the breast and 627 controls), Myriad found the SNPs added “significant cancer of the breast risk discrimination” far above what’s achieved using the Tyrer-Cuzick model alone.

Having the ability to precisely evaluate an individual’s five-year and lifelong chance of developing cancer of the breast is helpful and actionable often. The apparent benefit is perfect for patients at high-risk from the disease. Within the U.S., cancer of the breast may be the second most diagnosed cancer and also the second leading reason for cancer dying in females. Early recognition is essential.

Many groups, such as the American Cancer Society and also the American Congress of Obstetricians and Gynecologists, suggest that if your lady includes a more than 20 % lifetime risk for cancer of the breast, she ought to be offered magnetic resonance imaging (MRI) alongside her annual mammography exam. Adding a breast MRI increases recognition sensitivity in contrast to mammography alone.

Around the flipside, the mixture of the genetic panel, the riskScore test, and also the Tyrer-Cuzick model can identify ladies who possess a less than average chance of developing cancer of the breast. Plus the validation study, Myriad presented data on Wednesday from the separate research into the combination testing approach, which delivered lifetime risk estimates that ranged from .88 percent to 66.4 %. If your patient includes a under 1 % possibility of developing cancer of the breast, her screening regimen could be less.

Lancaster believes that positive news is frequently a missed chance. Doctors, particularly oncologists, tend to pay attention to how to proceed, not what to avoid, he stated. The potential advantages of knowing someone reaches lower risk are huge.

“There’s the price-saving, the unwanted medical interventions, the right usage of healthcare sources in a population level but in addition, there’s the person patient and not simply their clinical management… but additionally I believe the anxiety level impact, the emotional impact,” Lancaster stated.

A lot of women endure days of tension around every mammography exam, he noted, conscious that this may be the entire year that clinicians look for a tumor. They could be at elevated risk according to genealogy, but other product idea how concerned they must be.

Somewhat, this will make adding riskScore a substantial milestone for that field. This means genomics is beginning to change from studying single mutations that individually increase disease risk, to some more nuanced studying of numerous genetic and lifestyle variables that combine within an individualized way.

While several academic teams have printed studies highlighting the need for polygenic testing recently, none have the symptoms of commercialized and validated their tests for this extent. Because of the sheer amount of data needed, Myriad used exterior databases to build up its test.

The issue at this time is the fact that riskScore only has been validated for ladies of European descent. Lancaster stressed that this isn’t because of any decision-making at Myriad, but merely because genome-wide association studies (GWAS) which have identified the important SNPs are usually in Caucasian populations.

“We are to some extent restricted to what’s available, in what studies have been done,” he stated. “But because the data builds up, we will certainly embrace the chance to grow, not only into other ethnic groups but additionally into other disease types.”

Cancers having a strong hereditary component will probably be next out there. That may include prostate, ovarian, and pancreatic cancers.

Simultaneously, Lancaster laments that some genetic tests, for example individuals for cancer of the colon, are woefully underutilized. Indeed, no matter how sophisticated the genetic tests become, the details are only useful when patients and doctors embrace it. (Myriad presently sells an inherited test for cancer of the colon.)

Meanwhile, women having a genealogy of cancer of the breast can order Myriad’s existing myRisk Hereditary Cancer test a 28-gene panel that identifies patients by having an elevated risk for eight hereditary cancers. If patients test negative for that 11 cancer of the breast genes incorporated within the panel, Myriad follows-track of the riskScore assessment totally free, while using initial sample. To know each woman’s personal risk, the outcomes will be combined with the Tyrer-Cuzick model.

Photo: Flickr user NIH Image Gallery

Steer clear of the flu before it stops you

Flu months are back, meaning it’s time for you to safeguard yourself and family members through getting a free flu shot.

Flu infections vary from year upon year, so it’s important to obtain a flu shot each flu season. It’s free for those who have Medicare, once per flu season when you are getting it by doctors or any other medical service providers (like senior centers and pharmacies) that take Medicare.

National Influenza Vaccination Week is December 3–9. Don’t allow the flu prevent you from experiencing the holidays. Get the free flu shot today!

Ex Nokia engineers’ clinical decision support startup helps doctors evaluate and treat bone fractures

Disior 3D analysis software for orthopedics

The cutbacks at Nokia recently have motivated former staff with mobile software and hardware experience, design and engineering backgrounds to construct their very own business or help others launch tech startups. One particular clients are an earlier stage clinical decision support business for orthopedics located in Helsinki known as Disior.

Chief executive officer Anna-Maria Henell labored for fifteen years creating virtual simulations and modeling systems for technology development and research organizations. A clinical advisor for that business, Dr. Risto Kontio may be the chairman from the department for Maxillofacial surgery in the College of Helsinki Hospital.

Disior’s software converts medical images into 3D images covered inside a mathematical grid that’s made to help physicians assess fractures and pinpoint whether an implant is required, where it ought to be placed, whether it may be minimized and just what movement would seem like. Physicians may use the interactive D images to optimize the mechanical force on the bone and also the screw interface, too.

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The conversion tool cuts a procedure that accustomed to have a couple of days lower to some couple of minutes. That may also prevent a fracture healing before it needs to be rebroken, reducing patients’ discomfort, discomfort, and medical expenses.

The main focus continues to be on wrists, ankles, orbital and facial fractures round the eye and jaw. We’ve got the technology will probably be combined with augmented reality goggles from Hololens.

Even though some hospitals in Finland will work with Disior, Henell can also be thinking about balance bigger U.S. market. Dealing with the Cambridge Innovation Center and Mass Global Partners, there is a startup bootcamp in Helsinki. Henell was certainly one of a number of health tech and medtech startups to become asked to pitch their technology to Boston hospitals for example Mass General. She stated their interactive analysis tools resonated using the hospitals she spoken with there.

Another avenue that the organization has an interest in exploring is dealing with bigger medtech companies. Another possibility would harness their tech for the advantage of training school of medicine students and surgeons in training.

MedCity ENGAGE, October 23-24 in North Park, concentrates on the most recent strategies and innovations to boost patient engagement, care delivery and company wellness. Use code MCNTAG in order to save $50.