Doctoral student on the road - third chapter

Roi Cezana reports in real time from a conference about a trip in the snow, carnivorous plants and problems in bioengineering

The truth is that although I ended the previous episode by collapsing on the bed and sleeping soundly, I could not persist in the situation for long. I spent some time sleeping on the plane, so two hours of sleep at the hotel was more than enough to replenish my freshness reserves. Curiosity burned in my veins: what does Antwerp look like outside the hotel? How does snow feel? How do people walk in streets full of snow and ice?

Time: 11 am, Saturday. Registration for the conference will only begin on Sunday at noon, and the opening lecture will be given on Sunday evening. I have almost two days to explore Antwerp, and I wasn't going to waste the opportunity lying in bed. So it's true that you have to prepare for the lecture, but you can also do that in the evening (which starts already at five in the afternoon, when the sun is setting in Antwerp). And in this spirit I put on my shirt, knitwear and coat again, put on my stocking hat and gloves, assembled the elaborate walking stick intended for the journey in the Rocky Mountains and I did not forget the umbrella from Israel. I gave up the ski goggles. Still, a bit excessive in the city, isn't it?

So that's it, no.

Walking down the street was enough to convince me that wrapping up in all layers was absolutely necessary. Still, the cold froze the body, but the atmosphere warmed the soul. Happy people walked down the street in every direction, in all colors and shapes. White and pinkish Europeans with pale gold hair side by side with people of Asian, African and Middle Eastern appearance. The street was full of all the wealth of human diversity, some in warmer clothes, some in real summer clothes.

There is much to tell from that day. I bought ice cream and discovered that for the first time in my life I can eat it at the pace I choose, because it hardly melts. I experienced my first snow - and it's an experience I recommend everyone to go through. It doesn't just fall from the sky - it floats and flickers in the air and creates shapes with the winds. There were years in Israel that it snowed, but it was only a poor imitation. It was only after I first saw real snow floating in the air that I learned to understand all the magical folk tales woven around it. It was a truly extraordinary experience.

I could go on and on about the carnival parade that passed me on the pedestrian street, with a cheerful tune, a drummer, a good musician, jugglers and young and enthusiastic dancers. The amazing thing was that they danced in the pouring rain mixed with snow and made everyone on the street happy. The tune was engrossing, and even though they were dancing in the opposite direction to the one I intended to go, I found myself drifting along almost involuntarily and taking videos of this intoxicating and addictive music.

In short, there is a lot to tell: about the food and the juicy steaks, about the Palestinian woman who told me about her experiences in Israel and about the amaryllis bulb I bought from her. On the giant carnivorous plant I met in a flower shop, whose trapping leaves could swallow an entire human hand and there would still be room for a fly or two. But as a number of readers rightly reminded me, it is appropriate to pay more attention to the scientific congress to which I was sent.
The best news about the congress is that it is taking place right in front of my hotel. You only have to cross the road, push the big glass doors - and you're inside. It's also very lucky, because all of Antwerp is currently flooded with snow and rain and even a short walk with an umbrella is enough to soak you to the bone.

The festive opening ceremony of the congress began at six in the evening, when the guests of the congress sat in the large auditorium, capable of accommodating over two thousand people. The organizers took the stage, one after the other, introduced each other and started with the solemn apologies. The Minister of Science of Belgium is, it turns out, stuck in a particularly bad traffic jam as a result of the weather and will be delayed. Sir Peter Manfield, who was supposed to give the opening lecture on lightning speed MRI himself experienced a health accident and had to cancel his participation at the last minute. Not pleasant, and we hope for his full recovery soon.
It was difficult for me to understand who each speaker was, so I collected a few representative sentences from the whole group, each from a different speaker: "Biomedical engineering contributes to medicine in a variety of ways - starting with syringes and ending with computerized tomography. The common theme for all of these is 'engineering for health'."

"You contributed, you are the lecturers, you are the conference, and I wish you all a fruitful scientific discussion... and more comfortable weather."

"It is our duty to contribute to better medicine for the sick and disabled."

"Antwerp is home to the diamond exchange, and if the budget allows you - you can take some home." (I wonder what the Technion's budget unit would say if I brought such a receipt)

After everyone had finished demonstrating their presence, we moved on to a lecture by the 'substitute lecturer', Professor Francis Koldarin, an expert in internal medicine and emergency medicine, who has already written twenty-four books and over one hundred and seventy articles. Koldarin focused his lecture on the challenges facing biomedical engineering in the coming years and shared with us his understanding of the future of Western medicine.

It turns out that there are some problems with today's biomedical engineering. First, the devices are becoming more and more expensive, and require high-quality personnel - doctors, engineers and surgeons and system administrators. Side by side with this fact, there are particularly profitable fields in medicine, such as radiology, which will be 'hijacked' by private institutes in the future. But not only fields are profitable - specialists of the right kind can also put good sums of money into the pockets of hospitals. This is why cardiologists, orthopedists and neurosurgeons - the three most sought-after types of medical specialists - will begin to leave the hospitals and move to private institutes. This process starts already today, and a continuous decrease in the number of those admitted to the hospitals can be seen, side by side with an increase in the number of patients receiving treatment elsewhere.

According to Professor Koldarin, the main problem with today's biomedical devices is in assessing the limited effectiveness of the new technologies, especially compared to their price. It is very difficult to know with complete certainty the degree of effectiveness of the latest medical devices, but the hospitals are required to pay huge sums to purchase them.

A good example of this is a new technology that recently entered the medical market in the form of a da Vinci robot used for prostate gland surgery. Although its effectiveness has never been tested with complete certainty, hospitals are investing a huge fortune in buying the system because, at least for now, it seems that surgery using the robot causes fewer side effects in the operated.

It doesn't sound so terrible, but another problematic technology lies in the 64-Slice-CT device, which makes it possible to obtain incredibly sharp images of areas of the patient's body, but involves a large amount of radiation in the operating process. It is likely that a patient who undergoes several such scans will be at risk of developing cancer - and despite this, more and more hospitals are buying the device and using it to diagnose heart problems while bypassing older methods - but also safer for the patient such as EKG and walking test.

The problem is not only in the damage that may be caused to patients, but also in the existence of technological systems whose cost is much higher than the financial profit obtained from them. A good example of this is the iMRT system for targeted treatment of tumors. In the best estimate of system usage, the hospital will lose a good few million dollars on a system that is used once a day. In the worst case scenario, the doctors at the hospital will not want to use the system at all.

Since a large part of the problem is related to medical manpower, Professor Koldarin made sure to emphasize that more should be invested in specialists. It is necessary to produce more biomedical engineers and increase the budget for specialist doctors in order to keep them in the hospitals and not lose them to the private companies. Another problem for which it is difficult to find a real solution lies in the desire of the young doctors to balance work and private life. 80% of private doctors want to reduce their working hours, provided this does not harm them financially. But actually, that's what most of us want anyway. More worrying news is that 66% of doctors are not willing to work overtime for extra pay. From these data we may quickly reach a situation of lack of doctors in the hospitals.

What are the conclusions from all this?

First of all, technology is going to increase the cost of medicine. Perhaps as a result, the competition with external 'treatment units' for hospitals will increase, and the hospitals will find it difficult to deal with them effectively. The development of hospitals will be limited as a result of a lack of staff (but not a lack of budget). And last but not least, despite the increase in prices, the technology will become more portable and lead to the expansion of medical care at home, instead of in the hospital.

At the end of the lecture, the organizers announced that the Minister of Science was still in the traffic jam, and since that was the case - they informed him that there was no point in coming, and released us all to the festive opening dinner of the conference, based on cheeses, quiches, breads and fish. Myself and the student from biomedicine were busy most of the evening closely following one of the senior professors, one of the organizers of the conference, who was walking around with a silver fork in his shirt pocket. We tried to decide if he was aware that a large fork was sticking out of his shirt pocket, or if it was the result of the empty half-liter glass of beer he was carrying in his hand. Eventually, another professor arrived who was high enough to whisper in the first's ear that he had a fork in his pocket, and the aforementioned immediately took it out, explained that he knew it all along, and returned it to its place on the table.

Indeed, the intrigue in science.

Our story will continue tomorrow, Monday, with the description of the research that will be presented at the Fourth Congress of Biomedical and Medical Engineering. Don't miss the next episode of... "PhD student on the road"!