This week I attended the annual Cardiology Symposium where presentations were made on the developments and aspirations for the management of a variety of cardiac conditions. Without harping on too much about the medical I will try to provide some background to my pedagogy.
I have a particular interest in the management of patients that survive a sudden cardiac death. These are seemingly fit and well individuals who, without warning, suffer a cardiac arrest. The group that I see are the fortunate one’s who happened to be in the right place at the right time and therefore received CPR, defibrillation (shock) and immediate hospital treatment. Among a variety of tests to attempt to diagnosis a predisposition/explanation for this event they usually receive an implantable defibrillator (battery box attached to wires into the heart that provides a shock) should the event happen again.
What I learnt at the symposium is that these development of the devices for heart failure patients is going in the direction of a a device that resembles a rod, that sits in the heart and has capacity to wirelessly transmit data (such as heart rhythm and function) to a system that enables the physician to monitor the patients and remotely alter the function of the device to increase functioning of the heart.
This reduces the need for hospital appointments to interrogate the device for rhythm abnormalities or device malfunctions. I can foresee the future developments of this smaller device having defibrillation capability. This is exciting stuff in my world!
The adaption of the heart; with the heart being the symbolic essence of human life has made me question whether fabrication between “hybrid of machine and organism” (Haraway, 2001) has made the patient a cyborg.
The ability for the physician to learn about the heart function from the device is a post human pedagogy in itself but I would like to take this concept a step further…
A major concern I have with this patient group is the psychological trauma experienced by these patients and how to educate them about the condition. The technological advances of the device will inevitably result in less human contact between patient and physician…leaving a void in the psychological and educational support these patient require. I am neither an inventor nor a programmer but with knowledge in this field can see a future that uses a programme to assist in a patient’s recovery, adjustment and future with a cardiac device. I propose the development of a system resembling (if not exactly like) an app that provides an educational programme incorporating a programme of cognitive behavioural therapy (recommended in European guidelines for this patient group), access to peer support forums that are mediated by professionals and integration of the wireless data transmitted from the device to make support and treatment plans individualised to the patient. I envisage it being accessible via mobile phones, tablets and computers and will incorporate the most up-to-date multimedia that will appeal to the age ranges targeted.
This pedagogy resembles an amalgamation of; an online (bank-like) account, virtual community/networking sites and educational support systems such as WebCT but enters unchartered territory in terms of existing within a health care system – an environment that does not have an ‘undo’ or ‘erase’ feature should something go wrong. In discussing this with peers and colleagues I have had mix reviews as to whether this is progress or merely making the best out of a bad situation. It is commonly believed that ideally, these patients would have access to structured in-hospital support and educational programmes. To that I argue that making a person attend regular hospital appointments is costly to both them and the facility. As the devices are technologically becoming posthuman so too must the pedagogy used to integrate and support them.