January 14, 2000

Modern health care is proof that yesterday's science fiction is today's science. Just flash back to the 1930s, when the novel "Brave New World" portrayed the impossible: fetuses that developed outside a mother's womb, humans that could be molded through genetic manipulation.

In the year 2000, some believe this fantasy is close to playing out, with in vitro fertilization and the developing Human Genome Project, which promises to deliver detailed genetic roadmaps to enable better control over illness.

Clearly, medicine's reach is endless. In the MGH's 179-year-history, for example, some of the 19th century's science fiction is routine. A stopped heart is jump started. A baby born no bigger than an adult hand is kept alive and goes on to thrive. The ravages of cancer can be held at bay — at least temporarily. Doctors sew on a severed limb and give it function again. Drugs induce states of happiness, calmness and alertness. They conquer pain, induce sleep and promote weight loss.

The future is already on its way. Tissue engineering offers hope that one day scientists can grow any organ in the lab. Lasers hint of surgery without knives. And investigators have only begun to explore what is arguably the body's most significant and complex piece — the brain.

As we turn the corner and begin another hundred years of medicine, what can we expect? Will our children's grandchildren be able to order a new heart or lung on demand? Will cancer and AIDS be cured and forgotten? Will they be replaced by more evasive, more virulent, more bewildering diseases? Will doctors perform surgery without breaking the skin? Will hospitals be replaced by virtual care via the Internet? Or will disease and illness be prevented before they even begin, simply by viewing a person's genetic profile at birth and fixing any weak spots?

Judging by the past, today's scientific imagination will one day turn into scientific reality. In the year 2099, what medical miracles will enable people to experience firsthand what was once science fiction? Just imagine.