James D. Westwood

Aligned Management Associates, Inc.

ENIAC, the first electronic universal digital computer, was born on Valentine's Day 1946—a lifetime ago. It and its emerging peers were elephantine contraptions, but they evolved rapidly, increasing in speed and shrinking in size, adopting efficiencies of scale in reproduction and mutating continuously. Who are their offspring today? Five billion mobile phones and similarly ubiquitous personal and business computers in countless variations. What was once a costly academic and military project is now an everyday tool.

When Medicine Meets Virtual Reality launched in 1992, computers were already popular in most of the industrialized world, although relatively expensive and clunky. (Remember the dot-matrix printer?) The Internet was about to make its commercial debut, providing a means to link all these solitary devices into a communicating, sharing, interactive meta-forum. More so than print, the computer was image-friendly. Unlike television and cinema, the computer-plus-Internet was multi-directional—users could create and share a moving image. Cinema and TV were meeting their eventual heir as “virtual reality” arrived on the scene.

At MMVR, virtual reality becomes a theater for medicine, where multiple senses are engaged—sight, sound, and touch—and language and image fuse. (Taste and smell are still under-utilized, alas.) Simulation lets actors rehearse in any number of ways, interrupting and reconfiguring the plot to create the most compelling finale. Visualization alters costumes to clarify relationships, and shifts sets and lighting to sharpen focus or obscure a background. Impromptu lines are recorded for possible adoption into the standard repertoire. Audience members, who need not be physically present, may chat with the actors mid-performance or take on a role themselves. Critics can instantly share their opinions.

Whether the actors and audience are physicians, patients, teachers, students, industry, military, or others with a role in contemporary healthcare, the theater of virtual reality provides a singular tool for understanding relationships. Medical information can be presented in ways not possible in books, journals, or video. That information can be manipulated, refined, recontextualized, and reconsidered. Experience finds a wider audience than would fit in a surgical suite or classroom. Therapeutic outcomes can be reverse engineered. Precisely because the theater is unreal, the risks of experimentation and failure vanish, while the opportunity to understand remains. The availability and veracity of this educational virtual theater are improving due to steady technological improvement: this is the purpose of MMVR.

Most of the industrialized world is currently undergoing an economic correction whose end result is far from clear. The happier news is that many emerging economies continue to flourish during the downturn. Furthermore, knowledge resources that were once the privilege of wealthier countries are now more easily shared, via computers and the Internet, with those who are catching up. Children (and adults) are being trained on inexpensive and interconnected devices, acquiring literacy and a better chance at higher education. Healthcare is an important part of this worldwide dissemination of expertise enabled by the virtual theater of learning. As developing regions progress, their most creative minds can take part in the quest for what's next in medicine. The vision of a better educated, more productive, and healthier global population is clarified.

Someone born in 1992, as was MMVR, could be attending a university now. She or he might be working on research that is shared at this conference. We who organize MMVR would like to thank the many researchers who, for a generation, have come from around the world to meet here with the aim of making very real improvements in medicine.