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Monday, April 22, 2024
Dr. Brown: Accepting the future of AI – and the powerful role it can play in medicine
An AI image of a human and robot doctor. RICHARD HARLEY/ FIREFLY

Once hominin species developed the requisite cognitive underpinnings for imagination, creativity and symbolic language for sharing what was going on in their brains with those of others, a major threshold was passed.

This was especially true for modern humans and their cousin species, the Neanderthals and the denisovans, and perhaps earlier prehuman species as far back as one million years ago.

Cognitively so endowed, those species variants became better equipped to navigate the complexities of larger social groups and read the intentions of others.

With enhanced social intelligence came a rich imagination and a strong impulse to seek meaning in nature’s creative and destructive forces, night skies peppered with countless twinkling lights and a growing awareness that there exists another parallel world populated by spirits and gods (see Geoffrey Tristram’s article for SSJE, “Lord, Increase Our Faith”).

Those spirits and gods were probably the stuff of tales and legends, recounted by band storytellers or shamans whenever humans gathered together.

The power of the spirit world evoked by shamans was movingly captured by the famous paleoanthropologist Richard Leakey’s imaginative interpretation of what might have happened when ceremonies were led by a shaman in a trance within the caves at Lascaux, home to some of the most beautiful and moving cave art in western Europe.

If modern-day shamanistic stories are any guide to ancient practices, many of the latter’s creation stories probably spoke to the clan’s past, present and future.

Animating those stories would have been heroic figures from the tribe’s past whose powers and continuing presence, in some form, helped guide and shape group life.

Gods in charge of the sun, moon, waters and sacred places were probably among the earliest features of creation stories and would have been endowed with superhuman powers.

These were powers not unlike the anxiety, fear and power felt by many modern-day humans faced with the prospect of AI omnipresent surveillance.

What most of us think about when it comes to artificial intelligence are silicon-based computers embedded in our smartwatches, phones, tablets, and other computer devices, which have become ubiquitous in our lives.

Increasingly, smartwatches and other wearable devices are capable of monitoring bodily functions from pulse rate to blood pressure, the intensity and duration of physical activity, tracking the duration and quality of our sleep, and as aids for monitoring depression and the effectiveness of medications.

In the case of diabetics, other wearables track blood glucose levels and deliver tailored amounts of insulin to keep blood sugar levels within the normal range and do so far more effectively than a decade ago.

What worries the public about these increasingly powerful systems is whether these AI systems will threaten their jobs?

Not so long ago, professions such as physicians considered themselves immune to AI – getting the diagnosis right and developing plans for managing patients was thought to be too complex for AI.

Now, those assumptions are threatened.

AI learns and has the potential to offer better service than many clinicians because the database for each patient contains the patient’s entire medical records, including imaging studies.

This offers broader, deeper analysis for patients, meaning AI will likely be an effective partner for health care.

Other professional fields such as accounting and law will be in a similar boat and partners with AI will be, frankly, much better.

The path to partnership won’t be smooth, because of vested interests in the status quo of professional bodies like medicine and nursing – but it will be worthwhile once secure, high-quality databases are available on which to learn.

Wringing hands and fretting won’t solve the challenges posed by AI.

Recently I tested ChatGPT using several clinical cases that I made up, including an acute thalamic hemorrhage, cervical spondylosis, amyotrophic lateral sclerosis, basilar migraine and myasthenia gravis.

ChatGPT was spot on and helpful with its differential diagnosis, suggested laboratory tests, management, current treatments and ongoing clinical trials.

It’s at least as good as a resident in neurology and better than most neurologists outside their subspecialty.

Not bad for ChatGPT 3.5.

Dr. William Brown is a professor of neurology at McMaster University and co-founder of the Infohealth series at the Niagara-on-the-Lake Public Library.  

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