A NEW WISDOM OF THE BODY

ERIC J. TOPOL

Professor of genomics; director, Scripps Translational Science Institute; author, The Patient Will See You Now

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Back in 1932, Walter Cannon published a landmark work on human physiology, The Wisdom of the Body. He described the tight regulation of many of our body’s parameters, such as hydration, blood glucose, sodium, and temperature. This concept of homeostasis, or autoregulation, is a remarkable means by which we stay healthy. Indeed, there’s something of a machinelike quality in the way our bodies can so finely tune such important functions.

Although it’s taken the better part of a century, we’re now ready for the next version—Cannon 2.0. While some have expressed marked trepidation about the rise of artificial intelligence, this capability will have an extraordinary effect on the preservation of our health. We’re quickly moving to all-cyborg status, surgically connected to our smartphones. Although they’ve been called prosthetic brains, “smart” phones today are just a nascent precursor to where we’re headed. Very soon, the wearable sensors, whether they’re Band-Aids, watches, or necklaces, will be accurately measuring our essential medical metrics. Not just one-off assessments but continuous, real-time streaming. Obtaining data we never had before.

Beyond our bodies’ vital signs (blood pressure, heart rhythm, oxygen concentration in the blood, temperature, breathing rate), there will be quantitation of mood and stress via tone and inflection of voice, galvanic skin response, and heart-rate variability; facial-expression recognition; and tracking of our movement and communication. Throw in the analytes from our breath, sweat, tears, and excrement. Yet another layer of information captured will include such environmental exposures as air quality and pesticides in food.

None of us—or our bodies—are smart enough to be able to integrate and process all of this information about ourselves. That’s the job for deep learning, with algorithms that provide feedback loops to us via our mobile devices. What I’m talking about doesn’t exist today. It hasn’t yet been developed, but it will be. And it will provide what heretofore was unobtainable: multiscale information about ourselves and—for the first time—the real ability to preempt disease.

Almost any medical condition with an acute episode—like an asthma attack, seizure, autoimmune attack, stroke, or heart attack—will be potentially predictable with artificial intelligence and the Internet of all medical things. There’s already a wristband in development that can detect an imminent seizure; this can be seen as a rudimentary first step. In the not so distant future, you’ll be getting a text message or voice notification that tells you precisely what you need to do to prevent a serious medical problem. When that time comes, those who fear AI may suddenly embrace it. When we can put together Big Data for an individual with the requisite contextual computing and analytics, we’ve got a recipe for machine-mediated medical wisdom.