Talk of the coming “second machine age” seems to be all the rage. Machines will “man” factories, assist the aged, drive cars, drop bombs and packages and can help us with Internet shopping. Russian entrepreneur, Yuri Milner, Stephen Hawking and Mark Zuckerberg are even plotting to send a fleet of robots to Alpha Centauri. There is much debate over whether, with this much incursion into our lives, the bots will take away our livelihoods. The optimists argue that they will simply free us up to make more of our lives.
Regardless of how our new relationship with automation technologies develops, I am truly excited about the possibility that a certain class of bots might, in fact, make a dramatic difference to our lives – by extending them. A reality of aging societies is that we must contend with an increasing rate of colonoscopies, angioplasties and even nastier procedures. I take great comfort in the musings of the physicist, Richard Feynman, who spoke way back in 1959 of “swallowing” the surgeon as an alternative to all the nastiness.
In other words, bots can do good simply by being good for us.
Worried about how real all this might be? Feynman’s fantasy is not that far-fetched. I would divide the possibilities into three categories – the Now, the Soon, and Never-Say-Never-But-Don’t -Bank-on-It.
A little over 50 years after Feynman’s call to swallow, the FDA approved an ingestible device that transmits data on what time a patient might have taken her medication, the type of medication and other biometric information. The FDA also approved a pill that can take pictures and transmit video from inside the colon – for many, a more appealing prospect than the alternative of a colonoscopy. Of the several cameras-in-pills in development, there is one that applies fluorescence endoscopy and helps advance cancer detection. I have spoken with physicians – noted for their aversion to change — who are genuinely excited about such possibilities.
The plot thickens. A step further, the field of “edible electronics” brings even more intriguing ideas: ingestible devices, often called “nanobots,” that can perform biopsies, perform surgical procedures and even deliver drugs. These developments combine silicon-based circuitry, biodegradable materials, such as gelatin and indigo, and batteries that run on stomach juices, giving new meaning to the concept of the “potato battery.”
Last year, a University of California, San Diego team used micro-motor powered nanobots, propelled by gas bubbles produced by reactions with the stomach juices, inside a live mouse. These developments have been quickly followed up by even more efficient “micro-swimmers”, which are swarms of magnetically charged particles orchestrated by a combination of chemical bonds and magnetic forces; they open up clogged arteries by delivering drugs to soften the arterial plaque, drill into it using each individual particle’s rotation causing a string of such particles to twist like a corkscrew, and leave anti-coagulant medication to inhibit further blockage. Ingeniously, these micro-swimmers might re-purpose existing medical devices: adapted MRI machines can steer these magnetically charged bots – like drones – inside the body. Given such creativity in bypassing some of the high capital investments up-front, I am more sanguine about the plans for human trials as early as the end of this decade.
Micro-swimmers could displace some of the most commonly sought interventional procedures – stenting and angioplasty – increasing success rates from 60 percent for those with chronic total occlusion to, possibly, 80-90 percent. This is on top of reducing both recovery times and surgery risks. Furthermore, the micro-swimmers could carry drug payloads targeting a wide range of pathologies, from cancer cells to infections.
Perhaps the most ambitious – and least realistic — of all of these imminent breakthroughs is one envisioned by serial inventor and Google GOOGL +1.14%’s director of engineering, Ray Kurzweil. He predicts that, by the 2030s, nanobots attached to our brains “will provide full immersion virtual reality from within the nervous system and will connect our neocortex to the cloud.” It would be easy to write Kurzweil off as another frothy techno-futurist, except that, as reported, he has, since the 1990s, been right in his techno-predictions about 86 percent of the time. Kurzweil does not get to such high marks as a futurist by being modest in his futurism.
As long as you are not completely creeped-out by cameras in your gut or bots in your brain, it is natural to ask: what could stand in the way? I see three main hurdles.
The first hurdle has to do with how soon the various technologies are developed, can be made to work safely inside the human body without rejection, while the complementary ecosystem matures. This means that nanobot swarms are, at least, 10 to 30 years away.
A second hurdle involves getting buy-in from the different constituencies involved – the FDA in the U.S. and their counterparts elsewhere, medical professionals, insurance companies, and, most significantly, from creeped-out patients. Of course, this will also require entrepreneurs and their investors to come on board, despite the unfamiliarity of the risks. Never under-estimate the barriers attributable to buy-in, especially in the healthcare business.
A third hurdle relates to privacy concerns. If the established digital players, such as Google/Alphabet, are at the forefront, regulators and consumers would, rightly, have concerns.
Imagine the second machine age going beyond the humdrum chores of driving cars, slicing noodles or delivering packages or satisfying inter-galactic fantasies of the technology-obsessed. Imagine, instead, bots much closer — inside of us, clearing clogged arteries and, someday, curing cancer. I know, it seems like a lot to swallow, but it is a genuine opportunity for innovation to do good by keeping us well. That would improve the human condition in a most visceral way.