I recently heard stories on two of my favorite podcasts, Radio Lab and Quirks and Quarks, that got me thinking about how inertia and reliance on technology can inhibit our ability to find easy, cheap solutions to problems.
The first story, at Radio Lab, was about a nursing home in Düsseldorf, Germany. As patients age, nursing homes risk that they will become disoriented and “escape” the nursing home. Often, they are trying to return to homes in which they lived previously, desperate that their children, partners, or even parents are worried and waiting for them.
When they catch the escapee in time, the patient is often extremely upset and an altercation ensues. If they don’t catch them in time, the patient often hops onto public transportation and is eventually discovered by police. The first outcome is, of course, traumatizing for everyone involved and the second outcome is very dangerous for the patient. Most nursing homes fix this problem by confining patients who’ve began to wander off to a locked ward and resigning themselves to physically or chemically restraining a desperate and emotionally-wrought patient.
An employee at the Benrath Senior Center came up with an alternative solution: a fake bus stop placed right outside of the front doors of the nursing home. Here it is:
The fake bus stop does two wonderful things:
(1) The first thing a potential escapee does when they decide to “go home” is find a bus stop. So, patients who take off usually get no further than the first bus stop that they see. ”Where did Mrs. Schmidt go?” “Oh, she’s at the bus stop.” In practice, it worked tremendously. This meant that many disoriented patients no longer needed to be kept in locked wards.
(2) The bus stop diffuses the sense of panic. If a delusional patient decided that she needed to go home immediately because her children were all alone and waiting for her, the attendant didn’t need to restrain her or talk her out of it, she simply said, “Oh, well… there’s the bus stop.” The patient would go sit and wait. Knowing that she was on her way home, she would relax and, given her diminished cognition, she would eventually forget why she was there. A little while later the attendant could go out and ask her if she wanted to come in for tea. And she would say, “Ok.”
Listening to this, I thought it was just about the most brilliant thing I’d ever heard.
The second story, from Quirks and Quarks, was regarding whether it is true that dogs can smell cancer. It turns out that they can. It appears that dogs can smell lots of types of cancer, but people have been working specifically with training them to detect melanomas, or skin cancers. It turns out that a dog can be trained, in about three to six weeks, to detect melanomas (even some invisible to the naked eye) with an 80-90% accuracy rate. If we could build a machine that was able to detect the same chemical that dogs are reacting to (and we don’t know, at this time, what that is) it would have to be the size of a refrigerator to match the sensitivity of a dog’s nose. When it comes to detecting melanomas, dogs are better diagnosticians that our best humans and our most advanced machines.
This 2 1/2 minute video, from 60 minutes, is of a dog being trained to detect bladder cancer by sniffing urine samples:
But do you see dogs in our medical centers anytime soon? What would the malpractice and hospital insurers say!? Do you think people, even those not scared of dogs, would trust one? Is it because we fetishize “authority” and “technology” to the point where we feel more comfortable getting our diagnosis from a man or a machine, even if men and machines are inferior to the task and wildly expensive in comparison?
Please feel free to disagree with me in the comments, but I don’t see dogs in our medical centers anytime soon. I do think, however, that there is some really wonderful possibilities here to deliver low cost cancer detection to communities who may not have access to clinical care. A mobile cancer detection puppy bus? I’d go for a good sniffin’.