It was quiet and cold in the waiting room. We’d been outside in the humidity for so long that the air conditioning left me on the verge of shivering. I sat, waiting for the minutes tick away with nothing to do but think about the trip.
I was trying to remember how long it had been since I’d actually traveled in the real world. I couldn’t place it—twelve years was my best guess. As a young doctor, I vacationed, went to conferences, visited friends and colleagues, and flew to dozens of hospitals to harvest organs. But those days were gone so fast that no one had time to realize what was happening.
Neural adjunct technology had come so far since the early days of implants for Parkinson’s and epilepsy. It eliminated any need for travel. Now we didn’t even need to physically go to work anymore. Never would I have pictured a day when a doctor wasn’t needed at the hospital. But here I was, helping to bring that very thing to Indonesia.
And that was Amy’s doing—her vision.
From the time I’d first met her as a med student, Amy’s goal was to advance the logistics of automated medicine. She saw a widening gap, as wealthy urban populations benefitted from the vast gifts of modern technology, while the poorer, rural peoples were getting left behind by the rushing wave of technical advancement.
Amy feared a future where the human race diverged. Those with access to gene therapy and neural adjuncts would continue to grow and develop, creating a more integrated, more advanced society in a second-layer reality. But those without access to these miracles of modern technology would stagnate, becoming increasingly marginalized, and even relegated to second-class status by the majority urban populace.
She believed that remote automation of medicine could help bridge that gap. And recent advancements had made her vision more attainable. It was time to start bringing it to the rest of the world.
She asked me personally, as an old friend and long-standing member.
“Indonesia?” I said. “Have you gone mad, Amy? It’s dangerous in those rural areas. Not only am I not going, I don’t think you should go either. Does Davis know about this?”
“Davis is supportive of whatever I do, Earl.”
“So you haven’t told him yet, then?”
“Not specifically,” she said. “But that doesn’t matter. He’s always behind me.”
Amy was headstrong. She kept planning and persisting: years before the technology was there, she was scheduling deployment of it, struggling to find ways to get it into as many third-world areas as possible. She raised funding, built support networks, and recruited other doctors to help take up the cause.
I watched. I was too engrossed in my day-to-day routine in Boston to get involved with her campaign.
At times I had to remind her, “Amy, you have obligations here too. Look after your patients first, then you can devote time to your side projects.”
“It’s not a side project,” she would fire back at me. “People in Boston get the best care in the world, Earl. These people get none.”
That’s where her real interest was. And there’s no doubt her passion brought the field along faster than it would’ve moved without her. If anyone wanted to know about remote medicine, eventually they had to talk to Amy Long.
She began her own foundation dedicated to directing medical research funding toward her goals—a bit like a pirate charity, consulting with other foundations, and convincing them to invest in certain types of research. She also published a media guide and held conferences.
Her work supported the proliferation of larger gene labs, so that the American model was already built around remote medicine. That way, the infrastructure was already proven. There wouldn’t be any need to design new infrastructure when the time came: it would just be a matter of copying the existing system.
Before we knew it, gene labs were taking swabs by courier and returning individualized gene-based nasal sprays within days. Amy had a huge hand in making all that happen.
When scanning and diagnostic tools became small enough, Amy was the first to develop methodologies for putting them into the hands of patients directly. The smaller and more user-friendly a device became, the easier it was to eliminate the need for patients to come to the hospital. At first, it was via video conference and glasses; then, it was the early virtual reality programming, which gave way to full-immersion second-layer programming. Her hand was there guiding the helm.
“The final piece,” she used to tell me, “will come when neural adjunct placement can be done remotely or robotically. Then we can get it to everyone.”
A year before we left for Indonesia, Amy started planning. She had outlines for a system that would encompass the entire island of Borneo.
“Cal Tech and Johns Hopkins both have robotic surgical systems producing comparable outcomes, Earl,” she said, when I asked her if she was jumping the gun a bit.
“But that’s under the direct scrutiny and supervision of some of the world’s best trained surgeons.”
“That’s the thing you’ve never seemed to understand,” Amy answered. “It doesn’t matter anymore whether the best trained surgeons are sitting outside the room pushing the buttons. They can be halfway around the world and be just as effective. And most of the time, they won’t even be needed. By the time we implement this, the robots are going to be better surgeons anyway. Our time is up.”
The more I looked at it, the more I came to understand just how right Amy was. I wasn’t sure whether it was Davis’s influence that allowed her to see things so clearly, but she always seemed to understand every nuance and every curve in the path toward medicine becoming a technological art.
She saw the next step just as clearly. “From here on out,” she said, “it gets political.”