Medicine in 2037; better, or just sci-fi?

One of the developments I thought up that would be commonplace in the year 2037, when Falling is set, was to do with medicine.

As I write these words in late 2023, especially post-COVID, we in the Western World are painfully aware of how overstretched hospitals are. Too many people are presenting with conditions and injuries they don’t really understand are self-treatable or which aren’t as urgent as anyone thought.

Plus, as our population ages and medical needs get more complicated and more politicised (if you smoke or drink excessively, does society still have an obligation to treat conditions arising from that with as much urgency as others?), more people need more medical help, and despite politicians crowing about much they spend on health, their behind-closed-doors policy is always to save money by cutting services – especially for poor people.

But before I turn this into Marxist rant, the point is that by 2037, with a little over nine billion people in the world (according to the UN estimate) and probably even fewer hospital beds per capita, keeping people out of the hospital systems will be a global health priority.

How did I solve it? By extrapolating from platforms like telehealth and devices like wearables. I figured that if you have something you’re just going to wake up from and be okay after they treat you there’s no need to keep you in hospital taking up a bed and capitalising staff resources you don’t really need.

Instead, they take you home, enlisting your next of kin to let you into your/their house, making you comfortable, etc. They set you up with the whole hospital experience as much as possible in a walkaround drip, oxygen, etc, and some instrument attached to you takes vital signs and reports on your progress or tells them when you’re awake.

Telecommunications technology can then put them in constant touch with you, telling you what’s going on, what you should do and when, when it’s safe to get up, whether a doctor will come and visit to complete treatment, etc.

Is leaving an unconscious patient alone in their own bed when they’ve just had an operation or been in a coma for three months irresponsible? Probably – I’m not a doctor (although you’d probably have to be a lawyer to appreciate how problematic the whole field would be).

But there was a specific narrative point too. Dale goes to hospital after his initial freakout on the train while crossing the bridge for the first time in over 20 years. Again when Vicki accompanies him onto the bridge for direct exposure therapy and it all goes terribly wrong.

He’s there again after his ill-advised flight up the bridge pylon by himself, again after the expedition that ends in tragedy for so many of the party and again when it looks like he’s going to have to get the brace deactivated and removed because of the danger it poses.

Of all the locations in the story, it felt like one place the characters spend the most time at is hospital, a place that has no direct bearing on the plot – other than it being just where you go when you get hurt.

It was feeling very repetitive, so I had to get people – especially Dale – out of hospital. The solution was to have him wake up and recuperate at home, connected to medical equipment that alerts his health service when he’s awake.

Once there, a nurse calls his phone and explains what’s gone on, prepared to calm him down if he’s disoriented or panicky, coaching him through disconnecting himself from user-friendly machinery and leaving him comfortable in his own bed to recover at his own pace.

I’ve had sicknesses and injuries that have needed hospital visits in my family over the last few years and if you have too you’ll know hospital is the last place you want to spend more time than you have to. Maybe there was an element of wish fulfilment in it too, but I like to think we’ll do mass market emergency healthcare much better in 15 years than we do now.