A Visit to the Oncologist-in 2057

Craig R. Hildreth, MD

Author’s note-with several pundits prognosticating that in the near future we will be able to meet all our health care needs with minimal or (ideally, to some wags) no interaction with doctors, let’s take a glance at how it might play out. Below are notations from a cancer patient’s diary, chronicled in the year 2057.

Dear Diary,

Crap! (No joke). Today was just a lousy day-I had a couple of episodes of diarrhea at work, and my rash is itching me to beat the proverbial band. I’m home but wiped out-going to call Hallie and take a rain check on our date tonight.

I am seriously thinking about firing my oncology software. It has been 19 months now since I found myself stuck with this relapse, over four years since the original diagnosis and I feel like I’m slowly getting worse. I don’t dare tell my father anything yet-he’ll start going on about how I should see a human doctor. He has been pushing me to visit a LiveDoc who supposedly is still practicing oncology in midtown. Right-like I’m going to do that. While I’m at it why don’t I also buy an old driver-controlled car? I read somewhere that 75% of all Americans use only medical apps for checkups and prescriptions. I think for cancer it is over 90%, and it should be. Can you see me sitting in some stale office and saying, “Excuse me, Dr. LiveDoc, would you feel my liver and then tell me what the correct bioregimen is for me?”

Four years and counting! Good thing I had enough savings back then to purchase Cancer Solver. All the reviews at the time said it was the best, and I agree, but lately I find myself arguing with it. I queried it (again) last night and the Solver said “Restart prednisone for your rash.” I mean, I know it will work, but does this genius even care what prednisone did to me the last time I took it? Before I consider making a change, I better review my history. Of course, the main facts I pretty much have memorized:

June 2053: Weird mole appears on back; (90% positive ID for melanoma with MOLESCAN app for iPhone22s).

August 2053: Mole excised at Walmart (after the usual delay). Of course it was a melanoma, 3.5 mm thick, > 1 mitoses per mm², BRAF/PPP63/RAK1 mutated, overexpression of APOP-7 (the “Grim Reaper”-Har-de-har-har!); no sentinel nodes found on Thulium-169 PET/CT.

Adjuvant therapy (home delivery, of course) given: aristofenib/trivolumab/gobelalesib for one year, one long year I might add…which reminds me, I wonder how patients survived this before synthetic marijuana?

December 2056: Pain and nausea all over, and relapse (!!) in retroperitoneal/mediastinal lymph nodes and lungs-while on vacation! Good thing I did a peer-to-peer request to get a scan approved-who knew there were USACare kiosks on the Delaware boardwalk?

So now I’ve been on triple-drug therapy for 19 months and counting, chained to this unpronounceable treatment (lots of x’s and z’s); But don’t get me wrong, I’m glad it is working-or is it? Could my symptoms be a warning sign that the cancer is growing? I think I just might google one of the other oncology programs-you know, get an old-fashioned second opinion.

Dear Diary,

No time to go into details, but yes, the tumors are larger and yes, the wizards who developed ConquerMelanoma are a bunch of idiots. I tried their recommendation for a month and all I got was mouth sores, followed by no response and a tweet from my USACare nurse practitioner reminding me to not drink grapefruit juice while on this regimen. Maybe Dad is right-I am going to make an appointment to see the LiveDoc. For obvious reasons I am not going to announce this on any social media, except maybe InstaFamous (somebody showed me how to post anonymously there).

Dear Diary,

Hey, I know it’s been awhile, but guess what? THINGS ARE BETTER! Not only that, but I truly love my human doctor. She ain’t exactly young, but she is smart, an excellent listener, and is a heck of a lot more flexible than my software advisers. When we met she had already reviewed my entire history and (now don’t laugh) even did a physical exam. She reads a lot of the studies and told me about a new treatment developed in China, using a two-biologic combination that hasn’t been approved by ASEWIPE yet (American Salutary Estimation Welfare Investigation Panel on Effectiveness-one never gets tired of writing that out-Har!). Well, with her help I got the bios from Cuba and guess what? My tumors are ALL shrinking!

The future is no less scary now than at the beginning, but I am confident of one thing for sure-I am no longer alone in my fight. Thank you, Dad, for badgering me to see a real human doctor. The way I see it, as long as we still interact with each other, real doctors will always find a place in medicine. May they survive long enough to stage a comeback into American healthcare, and as my grandmother likes to say, “No, there isn’t an app for that.”