wordboydave said:
Maybe I'm crazy, but some of the premises of Traveller seem not only wrong, but literally unthinkable. Just based on what we already are seeing now, for example, I have a very hard time picturing a future where we don't have little nanites in our bodies constantly fixing things...and it certainly seems like there would be very little for a medical professional to do. Given enough stats and bioinformation, the AI of even fifty years in the future ought to be able to deliver prognoses more accurately than human doctors do...and then it'll just be a matter of obtaining the drugs. I don't see how medics fit into any real future scenario. (Relatedly, I don't think anagathics are likely to be necessary: we'll have self-renewing stem cells and live a very long time, making the age tables on the Career Lifepath distinctly irrelevant.)
Yes and no. If smart nanotech (as in, robotics as a nanoscience, rather than just materials science) becomes a thing, I can see medical nanotech being a big thing.
However, that changes medical science, it doesn't replace it.
A doctor today doesn't need much ability to successfully breed and keep leeches, for example.
Medical Nanorobots are, ultimately, 'smart viruses' - they may be intelligent as a swarm, but there's a limit to how smart an individual component can be. Having viruses constantly wandering around your body looking for bits to poke might help some conditions (say, cholesterol buildup) but could actively exacerbate others, particularly if they go wonky. If a nanoswarm decides there's something wrong with your elbow joint and wants to fix the problem by laying down a new layer of cartilage, fine....unless the new layer ends up lumpy and does more damage, or even starts expanding beyond what it should, in a sort of inert-organic-matter-tumor.
Many of the worst medical conditions you can suffer from consist of your body's own immune and regenerations systems 'deciding' that you have a condition that you don't actually have and trying to 'fix' it. Since the putative medical nanoswarm is going to be working off the same queues - temperature, blood pressure, protein and hormone levels in the body, it's quite believable they could make the same mistakes.
Equally, having nanotech hunter-killers in your bloodstream is fine but pathogens have been confusing and evading their biological equivalents for millions of years. You're not making them redundant, just offering them reinforcements.
So, yes. A medic would have less to do for an average person. But there would still be a need for the medical profession - it might morph into something somewhere between a current doctor and a medical nanotech tech support guy, but the role will still be there.
Equally, 'gross surgery' is something nanotech can help with but can't solve.
Say "There is a slight constriction of the left brachial artery due to deposited material" and the nanoswarm says "Yessir! On it!"
Say "There is a length of fractured 1/4" steel pipe through the lower torso" and the nanoswarm says "And aside from bleeding and peritonitis, what to you bloody think we can do about it?"
Others may quibble with my idea of where medicine is going, but surely everyone can understand why I might have a problem with human beings learning--and attempting to be expert in--a subject as readily computerized as Astrogation! If spaceflight ever becomes common, the most obvious thing to do will be to let computers handle the math! The very existence of a skill like Astrogation seems to rely on an old Age of Sail model where a lone navigator peers into his mysterious sextant, and, using arcane knowledge, tells the rest of the crew where to go. That doesn't seem even close to plausible.
And yet, solar and astronomical navigation is still a ship taught to maritime officers, and said officers still exist. Because:
1) Understanding the fundamentals of how you do astronavigation lets you evaluate the computer's output intelligently, even if you don't do the sums yourself.
2) Understanding the system lets you optimise it. A 'dumb' computer will calculate a safe/legal/viable route based on the request you give it, but the expert user (or the expert system!) will be able to say "hmm....I wonder if this option would be better instead?"
3) Being able to do some elements of calculation means that you're not helpless if the computer breaks. Granted, detailed orbital calculations worked out on paper is a stupid and unworkable idea, but orbital mechanics calculations sufficient to get you back into communications range of someone who can do the rest of the job for you, using spread-sheets you've created on a hand computer not optimised for the task, isn't an unreasonable idea - and the sort of thing I can see happening if a ship mis-jumped badly and the resulting systems crash took the nav computer with it.
But most of all, when I look at making ships, I just want to get rid of Traveller's absurdly limited computer rules. Why in the world would you install ships guns and then not have a program able to run them? Why wouldn't that simply go without saying? Ditto for Pilot, Maneuver, and all the other self-evidently necessary programs that the system insists that you buy. That's like making you buy doors, but also choose locks and handles.