Communication Where it Matters
An esteemed surgeon recently told me that virtual reality (VR) has no future in surgery. He had tried it in the late 90s and saw no practical application for it. As a technologist and VR designer I had to prove him wrong. I don’t see VR as any single product, but as a medium for the next era in the evolution of global communication. Online app stores provide efficient markets where millions of software creators give and sell to billions of customers, who rapidly set the standard through demand. The barriers to entry for developers are very low, so there is an endless supply of great minds. The tool that makes this connectivity possible is the internet, and the tool that will make collaboration between all these minds even more seamless will be VR. We had books, then the telephone, then video calls over the web. VR will bring us telepresence. And VR combined with robotics will enable surgeons to operate remotely.
One of my favourite films growing up was “Fantastic Voyage”, in which a surgical team are miniaturised and sent into a scientist’s body via his blood vessels. I wondered how terrifying and exciting it would be to be ant-sized, exploring the world close-up. How easy would it be to stitch together blood vessels or sculpt a stapes in situ? Back in my medical days, sitting in my ENT clinic, I spent many hours doing procedures while gazing through a surgical microscope. I found myself wishing I could see a little more clearly or have more precise control while working in the limited space of the ear. If technology permitted, I could shrink myself, gown up, climb in, see clearly and fix the problem rather than admit yet another patient to the operating theatre, with the risks of a general anaesthetic. This was a huge motivator for me to start up Composed Health, where I endeavour to combine virtual reality and robotic technology that will virtually shrink the surgeon to the point that he or she will be able to walk around in the cavities of the skull and remove infected tissues, or finely stitch the surface of the eardrum as if it were a big base drum.
We are hurtling towards great change. In 2006, my phone was used to make calls and send SMS messages. Just 12 short years later, my phone recognises my face and voice, and reminds me that I should leave 10 minutes early to catch a flight. It knew because it read my emails, checked my flight time, and gauged road conditions live from drivers on the road using navigation apps. It’s remarkable how asking a device to dim the lights or play some jazz is normalised the moment the technology hits the mainstream. In other news, there already exists facial recognition AI that alerts you when another user uploads a photo of you, and the last Winter Olympics opened with a huge swarm of drones forming very clear, solid shapes not unlike Starlings’ murmurations. It’s hard to believe scientists are publicly discussing the possibility of autonomous drone swarms being weaponised and triggering an apocalyptic scenario. For better or for worse, our species is accelerating into a technology wormhole that will change the world unimaginably.
Last November I was at the Oculus Connect VR conference in California, where exhibitors demonstrated their software for the Oculus Rift. My first stop was the Cisco Systems VR boardroom. I donned the headset and picked up the hand controls and was immediately transported into a virtual world. There was fully functional virtual whiteboard, presentation screen, and a 3D model of an engine on the boardroom table that I could pick up and manipulate with my hands. It felt surreal but surprisingly natural to network and interact with other guests in VR as if they were standing in front of me. I pondered the possibility of a future where I could be abroad and drop into work virtually when I need to. The virtual boardroom was impressive, but the jaw-dropping exhibit was an app called Medium. I found myself in an infinite 3D world, much like the space Neo is transported to with Morpheus in film The Matrix. I had a paintbrush in my right hand and a menu of tools in my left, and I could paint and sculpt in a limitless world, while walking around and climbing through my three dimensional creations. Other users could log in and collaborate over the internet. Unlike the Cisco demonstration, Medium has no direct equivalent experience in real life - it’s effectively a bionic superpower. I mused on the possibility of other novel experiences with no real-life equivalent. What future use case does VR have in store that we haven’t thought of yet?
There is huge potential for practical use cases of VR in surgery. Picture a surgeon performing an operation. A small complication arises for which a more senior surgeon is required. Normally, a surgeon might call an experienced colleague, who gives advice over the phone. It's difficult to give advice for such a visual craft over the phone. Junior and senior are 20 minutes apart, and the wait will certainly cause delay to an already late-running operating schedule. A pair of VR specs and hand controllers would be ideal for such a situation. In an instant, the senior surgeon logs on and takes over, viewing the operating field through the junior surgeon's eyes, or via cameras in their specs, to be precise, and intuitively control the robotic arm clamped to the side of the table.
To go one step further, there is a near constant line of communication between surgeons and medical device manufacturers. VR telepresence would give surgeons the ability to call the manufacturer and beam into a boardroom with an engineer right after an operation. They summon the graspers from a menu and demonstrate precisely what their unhappy with. This medium would be like a sketch on steroids. The surgeon could even draw the problem with a tool in 3D and with a few clicks build a crude, but functioning virtual example of exactly what they want. The engineer now understands, and sends the alteration to the instrument design team.
Standing on the shoulders of giants: A quote more true now than ever before. It took the efforts of not just present humanity, but our distant ancestors to make the great technological progress of today possible, arguably the greatest example of inter-generational teamwork. A communications history that started with smoke signals has evolved into being able to instantly video call anyone, anywhere on the planet. It’s hard to remember a world without instant, always-on global communication, and before the internet, ideas of today’s technology would have been strictly confined to the realm of sci-fi. Virtual reality will enhance communication further, taking us away from flat screens and into an era of virtual teleportation and virtual presence anywhere, any time.