London Underground MapI love maps, however it was the London Underground that taught me that the map is not the territory.

So useful and elegant as a guide for travel from Piccadilly Circus to Hampstead Heath, the Tube Map is no more than a technology that simplifies relationships in space. My eye on the delightful and complex map while zooming around in the tunnels beneath the great city, I’d pop up like a prairie dog at each destination like an island. One long afternoon, after months inside the illusion that the map was London, a friend with a car showed me otherwise.

Human beings love technology. From the stone axe to the large hadron collider, we are bedazzled by the gizmos and our ability to create them. Fetishistic about our clothes, cars, and candelabras, the subtle technology of language is hidden in plain sight, forming the map of our culture and shared experience. And what, exactly, are we talking about? What are we saying with our clothes and why do we probe the nature of nature with spectacular machines?

Gizmo photoMore than anything, human beings love each other and wish to know and connect with each other. We wish to be cared for and to care for each other. In the face of illness and injury, we have always reached out to each other. When we hurt, we seek relief. When those we love are in pain, we strive to soothe them. We have always scoured and scanned the environment for the tools that will help us to serve because we are compelled to be useful. What we call healthcare today is simply the result of that longing to be useful in the face of pain, suffering, and mortality.

Modern medical technology is the map, not the destination. Our technologies have extraordinary power to bring value to people and society. We occasionally cure disease. We often restore function. However, we never alter the truth that we come and go, that we live and die, and that we love this life so much that we frequently fail to notice it is happening.

Telemedicine and associated technologies are the map and not the destination. We are just beginning explore these tools. Over the past 15 years, the use of videoconferencing is evolving. BeginniPeaceful Statue photong with hardware and infrastructure-intense pipes that connected rare and valuable academic subspecialists to primary care settings (what I call Telemedicine 1.0) and now episodic care of sniffles and ear aches leveraging ubiquitous cloud based technologies to individuals on their coffee breaks (Telemedicine 2.0). As a palliative care physician working with an extraordinary and inspired team, ResolutionCare, we are exploring Telemedicine 3.0 and restoring the deep traditions of kindness and relief that the most vulnerable among us long for.

I hope you enjoy these simple discussions about how people can best serve people by doing what makes sense for people.

With Love and Respect…

Michael