Tiresiias: "Back to the Future"

"The present is theirs; the future, for which I really worked for, is mine."

Nikola Tesla

My friends,

In 1901, Wilhelm Roentgen was awarded the first Nobel Prize in Physics for his discovery of what he called x-rays, also known as Roentgen Rays. This was the beginning of “in-vivo macroscopic medical imaging”.

In many of his previous posts Tiresias has waxed lyrical using terms such as “macro”, “micro”, “in-vivo”, “ex-vivo”, “in-vitro”, “post-mortem”, “post-mortem macroscopic”, “post-mortem microscopic”, “ante-mortem”, “ante-mortem macroscopic”, “ante-mortem microscopic”, etc etc. Tiresias has assumed a lot of his friends, throwing around such Latinate medicalese terms. He knows his friends and readers are well above average in such matters, but for today he would like to revisit what all this really portends for the future.

Therefore, back to Roentgen, who, with his first X-ray photograph of his wife’s hand, brought us the first “in-vivo (that is in life) macroscopic (naked eye) medical image"; this is all the medical imaging that we have now. It is imaging of the living structures using x-rays, x-ray scanners, ultrasound, MRI scanning, nuclear scanners, PET scanners. This has transformed medicine. Though macroscopic imaging is essential, most disease however happens at the microscopic cellular and molecular level, inaccessible to the panoply of macroscopic imaging we now have at our disposal. Optiscan Imaging Confocal Laser Endomicroscopy (CLE), for the first time, enables “in-vivo (in life, real time) microscopic imaging”. This is the beginning of “in-vivo”, that is in life in real time in the actual body, the visualization of the cellular and molecular level physiological and pathological processes. We, my friends, are now in 1901, in the stage of our technology. Did Roentgen, could Roentgen, imagine what that first x-ray image of his wife’s hand would bring forth in 100 years. Can we begin to imagine the future that confocal laser endomicroscopy will bring forth?