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Booster Shots

Take This Capsule and Call the Doctor in 2030

April 22, 2002|ROSIE MESTEL

Today, folks at UCLA will bury a small, cone-shaped container to commemorate the university's new replacement hospital in Westwood, currently under construction. If the officials' self-restraint is anything like mine, they'll be digging it up next week--but the idea is to wait until the year 2030, fully 25 years after the hospital opens. Then, with much pomp and circumstance, they'll open it and probably giggle at some of the odd, old-fashioned items it contains.

Like a sigmoidoscope--a foot-long snakelike item currently used to check colons for precancerous polyps. ("They used to do what?!" those future fresh-faced interns will shriek.)

Like a hospital bill. (Who wants to guess what a hospital aspirin tablet or bandage will cost in 2030?)

And like breast implants--both the silicone and saline kind. (Aesthetic medicine being what it is, we can't begin to predict the future of fake breasts. Who would have predicted 25 years ago that people would be getting together to eat and drink and jab their faces with bacterial toxins?)

Frances Ridlehoover, UCLA Medical Center's chief operating officer, says the staff was asked to contribute items that have been significant in medicine but that also reflect how rapidly medicine is changing. And the items poured in. Prosthetic limbs. An artificial heart. Nurses' paystubs. Masks and gloves and psychiatric drugs like Prozac and Zoloft--which may be the best we've got today but could easily seem like bashing a malfunctioning computer with a hammer in those far-off days of the future when we know lots more about the brain.

Also stuffed into the drum are doctors' all-important pagers (how quaint they will seem when everyone in the hospital is networked into a big, buzzing medical hive) and patient identity bracelets, which will be obsolete when people all have chips embedded under their skin like my pal's pedigree dog does.

In, too, are the latest protocols for treating people with HIV--and wouldn't it be nice, says Ridlehoover, if that item was the most antiquated of them all.

Twenty-five years mightn't seem long enough for things to change much--but you get an idea of what can happen by looking back 25. None of us had ever heard of AIDS. The hepatitis C virus hadn't been identified, and because of that doctors couldn't screen for it. At the time, the risk of getting hepatitis from a blood transfusion was as high as one in 10 in some parts of the country, says Dr. Douglas Blackall, co-director of transfusion medicine at the hospital. "Now that risk is conservatively one in a million: What a change!"

Blackall and colleagues contributed blood donor pins for the capsule, among other things. He thinks that long before 25 years are up we'll have fine red blood cell substitutes but we'll still need donors for things such as platelets and plasma.

Julia Benoit, a registered nurse and unit director of medical procedures, says a lot too has changed in gastroenterology, her own specialty. These days, there's more talk of colon cancer prevention, she says--of diet and exercise and getting one's colon thoroughly examined in midlife.

That's why she offered the sigmoidoscope for the capsule. Actually, there's already a movement toward routinely using a 4-foot long device, the colonoscope, for such screening. (But the time capsule's of limited size, and we don't want to shock future generations too much.)

As for what we can expect in the future, Benoit has seen fanciful scenarios painted before--and they've seemed pretty unlikely to her. At a conference a few years back, "they showed this anatomical drawing of a colon and a little thing with wheels on it that looked like a bulldozer--and they were talking about this little device going in and snipping off polyps," she says. "I remember thinking: 'That'll never happen.'"

But Benoit is rethinking this because, already, some UCLA patients swallow little pill-shaped cameras that meander down the entire gut snapping photos before coming out the other end.

And scientists are working hard at perfecting "virtual colonoscopies" that would allow colon polyps and cancers to be imaged from the outside without inserting anything at all.

It is sobering to consider that Ridlehoover and I will both be 70 when the capsule is finally opened. But by then, I'm quite sure, 70 will be young and the start--just the start--of the prime of life.

*

If you have an idea for a Booster Shots topic, write or e-mail Rosie Mestel at the Los Angeles Times, 202 W. 1st. St., Los Angeles, CA 90012, rosie.mestel@latimes.com.

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