Living longer — part man, part machine

Despite even the best laid plans, things still fall apart… and, as we age, that applies to us as well. Technology is playing an ever-larger role in medicine, helping us live longer, healthier lives.

Linear peaks and valleys sang out a familiar duet. “Beep, beeeep…. beep, beeeep” – the cardiac rhythm strip confirmed a healthy heartbeat of steady lub-dub couplets. My patient was hooked up to a heart monitor machine while undergoing cancer treatments. A lowered magnet gently touched down on the skin of his upper left chest and, like a covert force, acted with speed and stealth to transform this normal heart rhythm into rapid erratic peaks – “beep…. be- beep……….. beeeeep-bee.” The comforting couplets were gone. In their place, an arrythmia assumed unpredictable control of his pulse.

I placed the magnet, intending to induce an energy field and block the flow of electricity within the wires and circuitry of his implanted pacemaker. The device had been placed years prior to treat a fibrillation pattern detected in his atria – the upper cardiac chambers. By controlling its contraction cadence, the pacemaker had, for years, steadied his pulse and extended the functional life of his heart. With its pacing now deactivated by magnetism, his cardiac tracing reverted to its prior diseased state – forced again to rely on the haphazard electric signals traversing the aging nerve fibers of his heart.

Wires and nerves perform the same function: they send electric signals – one to operate machinery and the other muscles. When electrons travel on wires, we call it an electric current. When electrons pass along nerves, we call it an action potential. Electricity courses down human nerves like “the wave” courses around roaring sports stadiums, passing energy along row by row with fans quickly sitting, standing, and sitting again, in synchronized timing. When nerves age, they can lose this synchrony and convey no signal at all – like fans standing and sitting at random. A pacemaker solves this problem by conveying the signal by wire rather than by nerve.

This arrythmia was not my patient’s only foe. He had never smoked but now battled lung cancer, as well as arthritis, diabetes, blood clots, hearing loss, and other maladies of aging. I was delivering radiation to kill a cancer nodule in his lung that had been found by lucky accident. As radiation entered his body, its invisible energy threatened to damage the circuitry of his adjacent pacemaker. We first monitored, then magnetically inactivated, and later re-activated the implanted device – a safety precaution while delivering his radiation.

Technology was heavily hybridized into his care. In addition to his pacemaker, he had an implanted glucometer to transmit blood sugar levels to an app on his cell phone, wore Bluetooth-enabled hearing aids to amplify sounds waves for his failing cochleae, had an implanted vessel filter to catch blood clots upstream before they could lodge in his lungs, and two titanium knees that had carried him painlessly to bridge club and bingo nights for a decade. His grandkids had even gifted him a Fitbit to track his vitals and step count. Outside, fleshy and sweet, he was grandpa to many. Inside, metal and wires, he was nearing full cyborg.

“What caused my lung cancer?” he asked, amid our electric evaluation. “I don’t smoke.”

“Nothing,” I replied, “You didn’t do anything wrong to cause this cancer – it just happened. Lung cancer is rare in non-smokers but can still happen.”

“But how?” he asked.

Our bodies are comprised of 37.2 trillion cells – a number too large to comprehend. If each cell replicated itself just once during a lifetime (it’s many more times than once), over 16,000 cells copy their DNA during each of the 2.27 billion seconds that make up the average human lifespan. Think of it – 16,000 DNA copies per second. With molecules of DNA being made up of 3 billion individual bits of information, this is like copying a book with 1.5 million pages on 16,000 copiers each second. It’s unfathomable how efficiently our bodies copy DNA – but mistakes are still made and with so many copies, mistakes add up. Beyond an aging heart, ears, and joints, the microscopic machinery inside cells also grows older. Millions of proteins race around cells to unwind, copy, proofread, and operationalize instructions from DNA – like robot vacuums tidying our biologic floors. This autonomous machinery keeps our bodies balanced – but with age, accuracy declines, and cancer becomes just another part of growing old.

“Cancer is often just bad luck from DNA copy mistakes,” I replied. “If I sent you to photocopy thousands of pages of an encyclopedia, you would make mistakes and place pages out of order. When copying so much information, mistakes are unavoidable – the same occurs copying DNA. Environmental harms like smoking only add on additional risk.”

“Well, if bad luck, then I hope your radiation machine is my good luck charm,” he said with a chuckle, staring down the barrel of a linear accelerator aimed right at him – its inner wires and circuitry also hidden from view. “I’m lucky technology has advanced health care so much.”

I nodded my agreement, told him when his radiation was complete, and removed the magnet from his chest. Immediately his heart monitor again chimed in comforting couplets – “beep, beeeep… beep, beeeep.” No longer magnetically inhibited, his pacemaker resumed its work. He climbed off the radiation treatment table and walked into remission, part human, part machine – but still fully grandpa.

Cancer in Your Corner aims to advance public health, bolster community trust, and enhance reader understanding through medical storytelling. Dr. Hess is the Director of Radiation Oncology at Sierra Nevada Memorial Hospital. His views do not reflect official positions of SNMH, CommonSpirit Health, or Dignity Health. Some aspects of this article are fictionalized history but are based on a true story. Names are fictitious to protect confidentiality.