Meet the cyborgs next door

COMMENTARY--When members of a Florida family implanted tiny, scannable ID chips under their skin recently to drum up publicity for a struggling technology startup called Applied Digital Solutions, they were hailed as "the first cyborg family."

Applied Digital's technology -- designed for applications like helping wayward Alzheimer's patients -- is supposed to make keeping track of people as easy as keeping track of cans of soup. Each of the company's chips stores a number that can be cross-referenced to a database containing more information, such as a person's name, address, and medical condition. Applied Digital even plans to one day include a GPS locator in the chip.

As you might imagine, the stunt generated publicity but also controversy (which is almost as good, right?). Privacy advocates immediately raised alarms that such chips increase the potential for invasive monitoring. The Food and Drug Administration launched an investigation into Applied Digital, since it had never signed off on the chip's ability to link to medical information. And religious alarmists even warned that the rice-size chips, once implanted, would confer the mark of the beast.

All this uproar is a little misplaced, though, considering that Applied Digital's chip is unlikely to ever be widely adopted. It's not a terribly useful technology, even for Alzheimer's patients. Rather than being embedded in an implanted chip, the ID number could be put on a bar code attached to a medical bracelet, which would be far easier for an emergency room doctor to find. But -- ethical or unethical -- the eventual "chipping" of the population in some other, more useful, medical form is probably inevitable.

In fact, there are already millions of cyborgs among us -- if you define a cyborg as someone whose body combines the digital with the biological. Every person with a pacemaker or other implanted medical device is one, and the technology and information carried in those devices is far more advanced than what's inside Applied Digital's ID chips. Indeed, sophisticated medical devices are making their way into more and more parts of the body, including the brain, cementing our cyborg destiny.

But it's when these devices are connected to the Internet that things will become truly interesting. For instance, nearly all cardiac pacemakers and defibrillators collect data about the heart that can be gathered wirelessly by passing a wandlike device over the patient's chest. Such a patient typically undergoes this procedure every few months at the doctor's office. But last January, medical device leader Medtronic got FDA approval to let some defibrillator patients collect the data themselves at home and send it to their doctors by connecting the wand to a modem. Not only will it save patients a trip to the doctor's office, but the doctors will now be able to monitor their health remotely -- and more regularly if needed. Currently there are 2 million Medtronic pacemakers and defibrillators implanted inside patients' bodies that technically have this capability, although Medtronic is still awaiting FDA approval to roll out the service for pacemakers, its newest defibrillators, and other heart devices. That's 2 million people with the hardware already installed, just waiting to get plugged in.

And that's only the beginning. Next could be neurological implants, which today are used to treat advanced cases of tremor or Parkinson's disease that no longer respond to drug therapies. Like a tiny electroshock treatment, the implant's electrodes stimulate neurons related to motor control. No sensors are incorporated in such implants today, but Mark Rise, Medtronic's chief neuro-engineer, says that adding monitoring capabilities in the devices is "certainly a direction we are headed." Brain sensors could potentially help doctors better understand and treat neurological diseases, especially episodic ones like epilepsy. And, through an online link, it would even be technically possible for a doctor to remotely adjust the level of neural stimulation provided by the device.

Although such projects are still in the early stages, research into wiring the brain with electronics is advancing. Ken Wise, an engineering professor at the University of Michigan, is fashioning implants that can both stimulate brain cells and record their activity. Shaped like a button with circuitry on it, the implant is designed to rest directly on the brain surface, with electrode probes protruding into the folds of the brain. "We are trying to figure out how to bridge microelectronics to the cellular world," Wise says.

He believes these buttons will first be used on areas of the brain that control sensory or motor functions, since those are the best understood right now. For instance, such an implant, when placed on the auditory nerve between the ear and the brain -- or deeper in the cochlear nucleus -- and linked to a microphone in a person's ear, could theoretically restore a deaf person's hearing. The implants themselves are multifaceted -- the only limit to their use is our understanding of the brain itself. "You could presumably stimulate neurons in any part of the brain as well as record from them," Wise says. "But what it would mean," he's quick to add, "we don't know." At least, not yet.

Implantable sensors could also be developed to monitor nearly any serious ailment by keeping an eye on organ functions, blood pressure, glucose levels, blood toxins, and other variables. The cheaper the sensors become, and the less invasive the surgery required to put them in place, the more people will opt for them. If the data that the sensors generate were constantly being sifted by doctors' computers looking for irregularities, health care might improve, since doctors would have a chance to catch things early. And new information-based businesses providing people with customized health data about their bodies would be born.

Of course, medical treatments or diagnoses should never be wholly dependent on such devices -- computers crash, and networks go down all the time. And admittedly, the notion of monitoring -- let alone treating -- patients remotely is a bit unsettling. After all, if a doctor is able to keep a watch over your brain activity, what is to stop the government, insurance companies, your employer, or anyone else who really wants to get hold of the data from accessing it? That is a serious risk. Laws protecting medical data are like a sieve, and they certainly should be strengthened. Another barrier to misuse is the FDA, which should continue to approve only those medical devices that provide a clear health benefit.

"You can conjure up a lot of images of Big Brother monitoring the activity of your brain," Rise cautions, "but that's not where we're going." As he points out, the only way this technology will ever be adopted is if there is something in it for the patient. In the end, people will embrace electronic implants for one simple reason: Doing so will help them lead healthier, longer lives.

As an editor at large for Business 2.0, Erick Schonfeld contributes to the editorial development of the magazine, writes feature stories, and pens a weekly online column.