Herman Olifant, fifty years old and heavily overweight, should have taken more care climbing the steep slopes of Platteklip Gorge on Table Mountain, Cape Town. Feeling faint, he rested in the shade of some trees. He looked up at his wife, said “I don’t feel so good,” and fell over, unconscious – into the arms of a waiting paramedic.

It was no accident that the medical team was waiting for him. As he had been climbing, tiny sensors located in his body had detected the early onset of his heart-attack and had sent a message to the medical call centre via the Global Positioning Satellite network. The medical team headed directly out to his location on the mountain, in anticipation of the pending heart-attack.

The NanoBot technology required to perform the internal, automatic and remote analysis has received a great deal of attention in the press over the past few years but people were extremely reluctant to install any type of ‘robots’ in their bodies. Despite the medical community’s persuasion, the public remained unconvinced.

It was only earlier this year that Discovery Health, one of the world’s most dynamic medical aid and lifestyle companies, launched a new product offering dramatic cost savings on medical services – provided clients accepted an implanted NanoBot.

Herman Olifant was tempted to be an early adopter and received his first year’s medical aid contribution free. This weekend, it saved his life on Table Mountain.

ANALYSIS >> SYNTHESIS: How this scenario came to be

The applications of medical nanobots have been discussed. Uptake, however, will be slow without persuasive arguments to the public and innovative products from medical services companies. People need to know that the invasiveness and the hype is worth it.

1950s: ECG enters service
The Electroencephalograph (ECG) utilises a variety of sensors to provide real-time information to medical officers (heart rate, pressure, oxygen levels, etc.) and was the first type of remotely operated medical telemetry to enter service. Hearing aid devices also were developed in the early 50s.

Nobel-laureate, Richard Feynman, one of the pioneers of the Manhattan Project, discussed the idea of manufacturing devices molecule by molecule in 1959.

1960-80s: From pacemakers to nano technology
The first battery-operated pacemakers were implanted in the 1960s and operated for 18 months before needing replacement. The demand model entered service at the end of the sixties to provide stimulus only when necessary rather than at a continuous rate. Further innovations included electronic shielding so that radio frequency devices didn’t effect the pacemaker and computerisation allowing the pacemaker to monitor and react to any type of abnormal heart functions.

Defibrillators, electric devices that stimulated a stopped heart, were developed. Blood oximeters entered service allowing quick evaluation of patient oxygen concentration in their blood supply.

In the world of environmental research the first radio telemetry devices enter service to track wild populations of birds. In 1970 the first satellite tracking system was attached to a bear. The device weighed five kilograms.

Nihon Kohden, a Japanese firm, utilised phone and satellite systems to monitor ECG systems around the world. At its peak, 32 centres throughout Japan and 2,000 satellite ECG labs and offices were interpreting 1.5 million ECGs per year. This enormous database was used to develop the first generation Cardiofax interpretive ECG machines.

Eric Drexler coins the term: “nanotechnology” to describe materials and robots operating at the nano scale.

In the 1980s the miniaturization of the electronics in the platform transmitter terminal (PTT) and the addition of on-board sensors to collect data on movement, temperature, altitude, humidity, heart rate and other factors revolutionized conservation ornithology.

1990s: Digital ECG telemetry and the GPS
Patients were given freedom of movement by cutting the wires linking them to ECG machines. This allowed heart patients to undergo physical therapy and recover faster.

In 1993 the United States made their Global Positioning Satellite system available to the general public for free and on a continuous basis. This immediately unlocked a vast number of commercial opportunities, from surveying to time transfer and navigation systems.

In 1993, PTTs weighing 28 grams—about the size of a disposable lighter—were attached to peregrine falcons to test the PTTs’ capabilities on far-ranging species. In just two years, satellite studies revealed more about the falcon’s range and critical breeding, migratory and wintering habitats in North and South America than 25 years of conventional field studies and banding returns.

Satellite transmitters operate on an ultra-high frequency, sending out an identification code and other information to satellites that collect data as they pass overhead. Ground-based computers use the Doppler effect—shifts in the frequency of the received signal caused by the satellite’s movement—to figure out the animal’s location to within several hundred metres.

In 1999 the FCC established the Wireless Medical Telemetry Service, which designates specific radio frequency bands for medical telemetry in the US, including 608-614 MHz, 1395-1400 MHz and 1427-1429.5 MHz. Because neither land-mobile radios nor television are allowed to operate on these frequencies, this band is safe from the sources of RF interference that are common to medical telemetry.

2000s: Nano technology initiatives
President Bill Clinton of the US proposes a US$500 million a year National Nanotechnology Initiative. One day, such systems could lead to a “100 percent cure and prevention rate for every kind of cancer,” Clinton said.

Critics contend that the constant motion of atoms and molecules makes atomic-scale machines nearly impossible to construct. Heisenberg’s uncertainty principle – the theory that the more you know about a subatomic particle’s position, the less you know about its momentum, and vice versa – also argues against nano machines. How can you manipulate atoms if their component pieces are so hard to find?

The most potent attack came from Richard Smalley, Rice University’s Nobel laureate in chemistry. In 1999, Smalley was extolling the benefits of a world where “we learn to build things at the ultimate level of control, one atom at a time.” By 2001, he said, such control wouldn’t really be possible. The “fingers” we’d need to handle such a delicate task are too big, Smalley asserted in a Scientific American article.

Hobbled by a divorce, and deep into theoretical computer science and abstract math studies, Drexler largely stayed out of public view in the face of such critiques for several years.

The term “nanotechnology” becomes more abstract and is tagged to anything that is small and electronic.

In 2000 the World Health Organisation (WHO) produced a report that jolted governments awake about a growing threat to public health. Obesity, it said, was an epidemic. In some countries, more than half the population is overweight. In December 2001, the United States surgeon-general, David Satcher, gave warning that obesity could soon kill as many people each year as smoking, and not because Americans are giving up cigarettes so fast.

2004: The war against fat and sugar
Swiss Re announces that people who are overweight will have to pay significantly higher life insurance premiums. “Unless the prevalence of obesity is brought under control, consumers will bear the ultimate cost,” said Ronald Klein, head of pricing at Swiss Re’s Life and Health business group. “As consumers’ body mass index goes up, so too will their premiums,” he added in a statement.

Medical Aid companies follow rapidly and place restrictions against the obese.

(see also the MindBullet “Fat and sugar – the new tobacco” – link below)

2005-8: Obesity becomes the biggest health challenge
Obesity-related cancer becomes the leading form of death in the developed world. Health insurance companies hold an international conference in Sydney, Australia to discuss strategies to reduce their risk. Lifestyle directed policies, such as those of Discovery Health, which link exercise and nutrition to premiums become popular.

ECG devices are linked to pacemakers and PTT’s. The first devices weighed several kilograms and had a battery-life of less than a year. Today, technological breakthroughs have reduced the weight to 25 grams and the battery-life now is in the region of 15 years. Integration of mobile technologies with GPS are starting to make these NonoBots a reality for many.

Health companies demand that clients install these to qualify for attractive new policies. There is an outcry over civil rights in the United States and demad for the active pacemaker components to be outlawed. The device is to remain passive and simply inform medical staff if any health-related problem is detected. European countries opt for the more active approach and support in legislation.

2009: Commercial NanoBot Breakthrough
Herman Olifant experiences a heart attack and is rescued by paramedics anticipating his crisis.