Most would agree that the mastering of any skill requires improvement in observation, improvement in manipulation, and the autonomy to make those improvements. Today, when we speak of manipulation, what we seek is manipulation at the atomic level, while working at a sub-atomic resolution. As Drexler and others have pointed out, to date we have worked with atoms only in bulk. We have shaped them with stones, pounded them with hammers, milled them by computer control. The manipulation of individual atoms, in a deft and dexterous fashion, would fulfill a contemporary definition of mastery over fabrication.
The field of medicine also falls into the above category. Our organ systems are painted crudely with buckets of chemicals, and are edited and probed in the macro scale. Today, as we gain the capacity to treat organs at the cellular level, it may seem to many that working at the molecular threshold would be impossible. While these advances may seem out of reach, I ask you to consider the case of the lone monk, and the effect of a single improvement.
Until the mid-16th century, humanity relied on a written work infrastructure that would require the efforts of dozens of individuals and take months to reproduce a single book. There was the rearing and slaughtering of animals to produce vellum; the cutting and boiling of trees to produce the rosin used in the sizing of parchment; the mining of gold to illuminate, lead to adhere gilding to the pages, and the creation of other compounds and minerals for use in the pigments. Distillates had to be boiled and separated as solute for these pigments so that they could produce ink. Often this mixing of pigments needed to be done immediately prior to use. Each of these individual activities was the vocation of an individual or group of individuals. Each single activity took days if not weeks.
At the center of all of this, monks worked to maintain a monastery’s buildings and lands. They supported a number of their brethren, who toiled to produce a single copy of (for example) a bible. The total effort would take months. At the pinnacle of this organizational process, one lone monk toiled to keep the funds, supplies and food coming in; the orders and requests up; the quality, volume and output consistent. It was the only way to convey this information to other people with any measure of efficiency.
The complete King James Version of the Gutenberg project Bible weighs in at approximately 4,345,138 bytes, or 4.3mb. While writing this so far, I have been broadcasting approximately 1.5 bibles per second as uncompressed ASCII and could have sent a copy to every one of my contacts online, whose servers would have received it in just a few minutes. While we can deny perhaps the illustrative qualities of the work, the information of the Gutenberg version of the KJV bible would survive legibly, intact, and in perfect accuracy. Inverting this structure could provide a hashed file so that this data would be available to the internet-at-large. A PNG illustrated crowd-sourced version weighing approximately 40mb could also be torrented, once seeded, in about sixty seconds.
While the notion that we would one day possess the ability to treat maladies at the molecular level may seem absurd, it should be noted that what I have done while simply writing this article — broadcasting 22,092 copies of a 4 megabyte text — would have required several hours of effort just ten years ago. It took centuries to go from months of work to replicate a single book to minutes, and a decade to go from minutes to fractions of a second. As we master the observation and manipulation of matter, we can look forward to similar changes in medicine.
Although I am not holding an illuminated manuscript per se, I can posses a more than suitable simulacra thereof, and appreciate it in the same fashion as the original work. We have changed the nature of our relationship with those atoms and that idea of a book, in that we have the information and representation of the result of their arrangement; yet we do not have the object as much as we have the idea. We relate to it differently, but we also relate to it similarly.
This is precisely how we are going to proceed through the use of nanotechnology into the realm of atomic medicine. We are going to advance not just through the improvement of the body itself, but we will invoke an as yet unforeseen change that is going to improve the human condition in a way that is immediate and immense. Our relationship to ourselves will also be changed.
I do not know if people have really thought through the idea of replacing hemoglobin. Whether it is through Ralph Merkle’s respirocytes, or through other nanochemical constructs (containing CFCs, etc.), it has been said that we stand to improve our oxygen respiration and gas exchange, making it approximately 200 times more efficient. That is not 200% mind you, but 20,000%. The oft-quoted illustration is that this would grant the ability to take a breath, run a 5k road race, and then take another breath. While this is an interesting illustration, I think we need to consider how vast the benefit of this single technological application could be.
Today, many in the medical profession refer to the time we have to treat traumatic injury as The Golden Hour. Most agree that this is the window during which competent care must be applied before a patient becomes a fatality. Sadly, this window is not always an hour, but varies depending on the type and extent of injury. Currently irreversible brain damage, as a result of ischemia, takes place within minutes of cardiac arrest or stroke, with damage to other organs taking only slightly longer. Blunt force trauma from auto accidents sometimes needs to be treated within minutes. About 45% of people who die as a result of accidents — and 25% of combat fatalities — occur because the patient has bled out. Drowning generally occurs in 4 minutes, perhaps 8 if the water is cold, unless the circumstances are extreme. All of this could be prevented were oxygen transport handled differently — if we take into account the improvement above, and are willing to trade some efficiency for flexibility and utility.
What if we accept a simple 5,000% improvement? What if instead of 200 times more efficient, we accept a more flexible and redundantly backed-up system that is only 50 times more efficient? If we replace all the hemoglobin with a loose-pack of this “nanoglobin,” it could function similarly to a fuel cell membrane — a molecular conveyor belt performing gas exchange in our pores, bringing oxygen in while conducting carbon dioxide out to the surface.
The substrate would not move, instead moving the required molecules around the body. The body could then scavenge oxygen from any environment, whether in the atmosphere or submerged in any oxygen-containing fluid. In this manner it would be feasible to take a walk on the ocean floor, or take oxygen from the ice and snow on Mount Everest. Alternately, with proper cooling, you could simply obtain oxygen from the water you drink using a toolkit of natural salts and hydrochloric acid provided by your stomach (with some humor, I’d like to point out, the cation of this process would be “H+”).
At this point, our cardiovascular system would be largely bypassed, remaining, perhaps, only in place to produce systolic force and maintain the hydrostatic pressure within the organs. It could drive the lymph and the rest of the vascular cargoes around the body through a foam mesh of non-moving nano-media. This system would resemble more a tracheal system (the open respiratory system) of a dragonfly.
With sufficient advancement, this system could take over the interstitial fluid, plasma and perhaps even the immune and nervous system functions. With added capability and autonomy, it would control and adjust the incoming and outgoing chemistry, balance operational temperatures and efficiencies, and shunt resources around the body.
The Reformation-era written word infrastructure that took months to produce a single book now looks unnecessarily complex and quaint, a potential source of nostalgia for some. The technology discussed in this piece could refine — in a single decade — the Pleistocene-era physical infrastructure that took two thousand generations to develop and supports human thought processing. Whether or not the future finds us waxing nostalgic for our current limitations will remain to be seen. Personally, I think that lone monk would grab a laser printer with both hands and not let go – at least not until something better came along.