SIEMENS

Pilots do it. Train engineers do it. Even steam shovel operators do it. So why not experienced surgeons and cardiologists? Sure, most of our work is routine — isn’t everybody’s? But when an emergency situation suddenly arises in the operating room or cath lab, you’d better be able to keep a cool head and know exactly what to do. So now we’re doing it too: simulating high-risk situations in the virtual world.
Take this morning, for instance. After rounds, I hurried to one of our new training rooms where I logged into the hospital’s Second Life home. Unlike most sites, which ask you to immerse yourself through a proxy, such as an avatar, this one has such advanced computing power that it provides the illusion of a realistic interventional environment, complete with a virtual "problem patient" drawn from a vast library of documented emergency cases. All you have to do is identify yourself, put on your 3D virtual reality goggles and skin-tight haptic gloves, and within seconds a virtual patient — and they are disconcertingly lifelike — is downloaded.
The goggles and gloves, by the way, automatically establish two-way contact with the virtual scene thanks to dozens of built-in nano location sensors that are activated and powered by body heat and motion. The result is that every movement of the head and fingers alters the virtual environment exactly as it would in the real environment.
As I pulled up the patient’s electronic file, a chime alerted me that someone from another hospital had logged on and had requested permission to collaborate on this case. "Excellent idea," I said to myself as I touched the "Admit" icon that appeared on the display; after all, successful emergency care is all about good teamwork, and you can never be too good at that!
So a second later there she was, Dr. Janice, a young cardiologist with — and I have to admit that this is my one real weakness — blond hair and one of those little bunched-up ponytails that really gets me going.
But before my mind had a moment to wander, a virtual electrocardiogram (ECG) on the display began flashing and beeping, indicating that the patient had gone into ventricular fibrillation — spasms of the cardiac muscle that can lead to sudden death within seconds. At the same time, an androgynous voice from the patient’s file began calmly announcing "Fifty-nine year-old male with a history of smoking, obesity and poorly-controlled hypertension. The patient was successfully treated earlier for a cerebral hematoma. A ventriculostomy was performed via the right..."
"Quick, apply D.C. shock," said Dr. Janice even as the file voice droned on. Gee, she’s really on her toes, I thought as the patient twitched convincingly in response to the therapy. But then his heart beat and blood pressure began sinking. "Atropine," I said authoritatively. A glance at the ECG, however, indicated a developing myocardial infarction. A treatment plan had popped up on the screen and I chose a combination of Lignocaine, Heparin and aspirin in quantities that had been optimized for the patient’s condition to dilate the vasculature and improve circulation. Dr. Janice administered the virtual cocktail through the patient’s intravenous tube.
But we had to know more about the cause of the impending infarction. "Coronary angiography," Dr. Janice ordered, briefly looking up at me with a wink. "Sharp as mustard," I thought, repressing my curiosity about what Blondie might be doing for the weekend. A moment later a 3D hologram of the patient’s heart that fused the angio image with a pre-existing volume CT scan appeared on the screen. It clearly showed a total occlusion of one of the coronary arteries. "Patient entering acute atrial fibrillation," announced the androgynous file voice laconically.
"Oh brother, this is a tough one," I said to myself. "Ms ah, Dr. Janice, please administer 3,000 units of Heparin and Abciximab," I said with a tense smile, referring to a powerful anticoagulant and a blood thinning agent that would hopefully buy us some extra time. "And I’ll get a catheter in there to clear that obstruction," I added.
To avoid wasting a minute on routine procedures, the patient had already been outfitted with a catheter, so that all I had to do was grab a wireless, handheld device to steer the virtual wire into position. I watched the ultrasound-equipped tip of the device snake its way toward the obstruction as I looked down at the patient, the goggles allowing me to see through the patient as they would during a real operation by superimposing a CT image and the catheter’s coordinates on the patient’s anatomy with flawless registration.
"Any plans for the weekend?" I asked nonchalantly as the catheter reached its target and its balloon tip began to inflate. I squeezed a custom-sized stent into the vessel and began withdrawing the catheter. "I’ll give the patient twenty micrograms of adenosine to avoid any potential inflammation," said Blondie with apparently undiminished concentration. Then she looked up and added, "Were you thinking of Friday or Saturday?"
Suddenly, the procedure appeared to have been successful. The patient’s vital signs, including systolic pressure and sinus rhythm, started to improve almost immediately. Dr. Janice and I agreed on a medical regimen that would carry our patient to an uneventful cardiac recovery.
As we signed off on the training documentation, Dr. Janice looked up at me from the other side of the virtual reality wall. My spirits lifted in anticipation. "So where do you live?" she asked. "Sydney," I announced hopefully. "Oh my, that’s a long way from Montreal," she said, but then added playfully, "Let’s meet in Second Life. I know a great little place where we can have dinner and watch the stars come out."