Recently, a young relative was quite surprised to find out that I do not use a ‘smart’ phone. When asked why, my response was: "I will not use a phone that is smarter than I am". Of course, I was being facetious but only partly so. In the interests of full disclosure I must say that I acquired my first Blackberry some ten years ago but it was stolen soon thereafter. My second Blackberry was left in my desk drawer when I went on a summer trip abroad and on my return I found out that it had sort of exploded due to the heat. I was forced to buy a smart phone by my immediate family some three years ago but I am not sure where it is these days. And the old Nokia I use is quite adequate for my needs.

No, I am not a Luddite and not at all a technophobe. I actually bought my first computer some thirty years ago, and used e-mail in those olden days when they actually put out a ‘directory’ of all e-mail addresses! But I am a little worried about certain aspects of modern technology both in social and some medical fields. It is an accepted fact that many jobs in developed countries are being replaced by robots and computers especially the more mundane and repetitive jobs that can be done easily, accurately and reliably by robots controlled by computer apps.

The reliance on computer apps and robots can have many down sides also. In my years as an editor and then as a writer for different newspapers the advent of computers has made a major difference. A simple spelling checking programme makes life so much easier for both the writers as well as the editors. That of course has led to the point where egregious spelling mistakes pass through the editing process because a spell check allowed it. And many sub editors now are not required to be as well read to do basic fact checking. The problem with fact checking is that somebody in the editorial process has to know what needs to be checked. For instance, do ships flounder or founder?

All computer apps and programmes run on ‘algorithms’. I don’t want to go into what an algorithm is except that it is a logical progression that can determine a ‘most probable’ result from the data that has been entered into a computer. A few decades ago most editors would have known the origin of the word Algorithm. Today they would probably have to Google it to find that out.

To save everybody the trouble of pulling out their smart phones or iPads, Algorithm is from Algorithmi, the Latinised name of Muslim mathematician Muhammad ibn Musa al-Khawarizmi. Al Khawarizmi also gave us the word Algebra that comes from the title of his book on mathematics that includes the words: Al jabr w’al muqabila.

My basic beef with smart phones and other such technology is based on three things. First is that we no longer need to remember things. Forty years ago I knew dozens of phone numbers by heart. Now I have trouble even remembering my home phone number. Second, with all sorts of apps including games and social programmes, direct face to face conversation is becoming a lost art and you can see a group of young people sitting together but with their eyes fixed on their phones. More and more young people are becoming loners and depend almost entirely on their smart phones to communicate or get information.

The mental health problems due to social isolation are becoming important as we see ‘radicalisation’ of young people all over the world. This is not an area of my expertise but from what I have read in different places suggests that this isolation and radicalisation are becoming a serious problem and already when applying for a visa for the US, details of social network interactions are being asked for. The psychological effects of modern social interactions through technology rather than direct face to face conversations will be serious over time but whether they will be good or bad or just different remains to be seen.

Now to technology and medicine. I do feel sorry that I cannot remember all the phone numbers that I used to but on the other hand, fortunately I no longer need to remember the names, uses, interactions and doses of all the medicines I might need to prescribe. For the first thirty years of my life as a doctor, I had to remember the names of different medicines and much else about them. And yes, I could have at times made serious errors by prescribing the wrong medicines or two different medicines at the same time that could have a bad interaction. Now most physicians use pocket apps that help them with all these things.

Similarly, we now have computer assisted technologies that can perform detailed visualisations of structures within the body. CAT scans are one such test. CAT stands for ‘computerised axial tomography’. Basically, multiple simultaneous X-Rays from different directions are taken and then transformed by the computer into a three dimensional image -- a major development that literally revolutionised diagnosis and treatment of problems of the brain.

Technology has been of great benefit to medicine especially for diagnosis and somewhat in delivering treatment. About robotic surgery, a discussion some other time. The last area where a physician is still needed to make decisions is when it comes to the choice of treatment. It is in this area that the human doctor is having to fight it out with the computer algorithm. Computer algorithms have been developed for the diagnosis and treatment of most diseases.

The problem though is of GIGO a term we used when computers first became commonly used. GIGO stands for: ‘garbage in, garbage out’. In other words a computer algorithm is only as good as the information that is available to it. If a physician or more likely a ‘nurse practitioner’ that sees the patient for the first time puts in incorrect or incomplete information, even the best algorithm will put out a wrong diagnosis and treatment plan.

This is a common problem confronted by many physicians practicing in the United States these days. Physicians, based on their judgment (human algorithms), might offer a particular treatment plan but the hospital employees using computer algorithms decide on a different plan for the patient than what the physician ordered then that can be a problem, especially from a medico legal point of view. If a physician insists on a particular treatment that differs from some hospital algorithm and the patient does not do well then the physician can become legally liable for the bad result.

Eventually, these algorithms will become self-educating and correcting possibly to the point of sentience. That will be the rise of true artificial intelligence and that as predicted by some major scientists might see the end of humanity as we know it. But then even the industrial revolution a few hundred years ago changed humanity as it was known then.