"PLATO" on Line: Biomedical Communication in the Computer Age

PERSPECTIVES IN BIOLOGY AND MEDICINE Volume 32 · Number 1 · Autumn 1 988 "plato" ON LINE: BIOMEDICAL COMMUNICATION IN THE COMPUTER AGE THOMAS P. STOSSEL* One evening, while brooding about how to come to grips with an invitation to speak to a group of physicians about biomedical communication , I picked up and read a snappy-looking booklet that had been published by the American Association of Medical Colleges. Called "Medical Education in the Information Age," this booklet was a rhapsodic encomium to computerization in medicine—that is, as rhapsodic as abbreviation-happy, infinitive-splitting computer mavins are capable of writing. The possibilities for computerization are, according to this tract, limitless. As I read this material, I thought that perhaps I could talk about the effect of the electronic revolution on the information explosion . But as the transient burst of euphoria over discovering a possible topic faded, I despaired. What could I, a green eyeshade paper shuffler, for whom bytes are something one scratches, for whom rams belong in the barnyard, and whose discs simply hurt in the morning, say about electronic communication? Now I am not so medieval that I do not at least know something about computers. With the assistance of more modern colleagues, I have come to have a Digital terminal at home that connects with a mainframe instrument at my office. I logged on to this device and, tired of playing the electronic games, idly began to type in the incredible list of acronymic programs listed in the AAMC booklet that are now available, for a price, to the biomedical community: pdq, medline, dialog, nlm, genbank, An adaptation from an Oration in Ethics given at the Miriam Hospital, Providence, Rhode Island, May 14, 1986. * Department of Medicine, Harvard Medical School, Boston, Massachusetts 02114.© 1988 by The University of Chicago. All rights reserved. 003 1-5982/89/320 1-06 1 1$0 1 .00 Perspectives in Biology and Medicine, 32, 1 ¦ Autumn 1988 | 1 COSTAR, CADUCEUS, MOLGEN, MACMAN, MACPUF, SCHOLAR, WUMPUS, neomycin, and plato. Not knowing the secret entry codes, I hardly expected anything to happen, However, when I entered plato, something amazing did. The terminal began to smoke and make eerie rhythmic chanting sounds. Dazzling lights sparkled on the screen. Ijumped back in terror. Now the reason my computer system works at all is because a college student whiz kid constantly plays with it. The downside of the arrangement is the fact that occasionally he enters commands that wipe out the document on which one is working, and I assumed that these fireworks were his doing. But instead of a wipeout, a scene gradually appeared on the monitor. In the background were verdant rolling hills dotted with sheep and olive trees. In the foreground, next to a stone building with a peaked roof supported with doric columns stood an old man, dressed in a tunic. Moreover, he was speaking a language I could not understand. My daughter, who was doing her homework on the middle of the living room floor, had been able to ignore this startling event, thanks to the Walkman earphones on her head. Smelling the smoke, however, she took them off, and said with surprise, "Hey Daddy, the computer's speaking Greek!" I must explain here that I have grudgingly paid the bills for private schooling for my children and often wondered whether the hyperalimentary education was necessary, not to mention worth the price. But I had left to the wisdom of my daughter and her teachers the arcane decision that she would learn ancient Greek, although I considered it a waste of time. "Daddy, that man says he's Socrates and that he's like happy to talk to us." So, with my daughter translating, talk we did. "Socrates," I said, getting right down to the first priority, "I have been asked to give an oration about biomedical communication. But I can't think of anything important to say." "Well," said Socrates, "What kind of communication do you mean?" So I proceeded to address the father of philosophy as follows: "Despite an action orientation, the medical profession is obsessed with words, especially written words. Participants at all levels look to 'the literature' for...