In the current issue of the New Yorker, this piece by Jerome Groopman on how medical simulators are changing the way doctors are trained.
Martin is not a real patient but a mannequin, an electronic instructional device known in medicine as a simulator. In many ways, he looks and behaves like a living person: his blue eyes blink, his pupils dilate, his skin is pliant, and his chest expands and contracts as he breathes. If you place a stethoscope over the spot where his heart should be, you can hear authentic beating sounds. His lips, tongue, and windpipe can swell–as a person's would in the event of a severe allergic reaction–and his teeth can be knocked out.
Martin is connected by a cable to a computer terminal, and comes with software that enables him to mimic the symptoms of dozens of medical conditions, including septic shock and flash pulmonary edema. (His physiological settings can also be adjusted to correspond to actual cases.) When the students opened Martin's mouth to insert the endotracheal tube, they found realistic reproductions of a pharynx and an epiglottis. When they passed the tube through his vocal cords, it entered what looked like a real trachea. If they had pushed the tube too far, it could have slid into the right lung–a potentially grave error frequently made by novices. The X-ray in the scenario belonged to a man with acute pancreatitis, and Martin's voice, broadcast over a speaker lodged in his head, was that of a Harvard faculty member, speaking into a wireless microphone in the next room and imitating a patient in severe pain. A consortium of anesthesia departments at Harvard purchased Martin in 1993, for a hundred and sixty-five thousand dollars. A 2005 model, which can be put to sleep with real anesthetic, costs about two hundred thousand dollars. The session that I observed was hardly unusual. "Every group overdosed the patient," Oriol said.
