Action at a Distance

by Abe Gibson

As just about everyone living in the twenty-first-century can readily attest, recent advances in science and technology have completely transformed the way we communicate ideas, exchange information, and conceptualize distance. The world is shrinking, and the implications are at once bewildering, exhilarating, and terrifying. To help scientists, scholars, and members of the general public make sense of these dizzying developments, the Consortium for History of Science, Technology, and Medicine recently invited two eminent scholars to reflect on the technological developments that have enabled “action at a distance,” and to provide some historical context for these radical changes.

The first speaker, Dr. Jeremy A. Greene, physician and historian of medicine at Johns Hopkins University, noted that the digital revolution is not unique, and that rapid technological developments have often (perhaps always) occasioned both enthusiasm and caution. As evidence, Dr. Greene asked the audience to consider the historical development of “medicine at a distance.” Although traditional histories of telemedicine would start in the 1960, Dr. Greene pointed out that the practice actually began much earlier. Following the invention of the telegraph, physicians learned to transmit information about infectious diseases through Morse code, though it wasn’t until the telephone diffused throughout American society that the medical profession was truly transformed. As Dr. Greene explained, there was early enthusiasm for the telephone’s potential utility. For the first time ever, physicians could speak with their patients from a distance, and thus assess symptoms from afar. As is often the case, however, the telephone also produced certain anxieties. After all, the introduction of this new technology placed new demands on all physicians, especially those who were heretofore technologically deficient. What’s more, the average American’s expectations of basic care also changed. Physicians were expected to be accessible at all times. They became beholden to the invention.

While Dr. Greene explored technology’s influence on life-centric medicine, the evening’s second speaker, Dr. Mark R. Hagerott, explored technology’s influence on death-centric warfare. There are few people better versed in the subject. Dr. Hagerott previously served in the United States Navy for several decades, and currently serves as distinguished professor of cybersecurity at the United States Naval Academy. He began by describing the various ways in which one could engage the theory of technology and war, acknowledging that he would be discussing theories of technological change and cybernetic theories of warfare. The greater majority of his talk centered on three different realms of warfare. The first realm he labeled “social-human.” This is the realm in which action is mediated by human thought. Tools may leverage human action, but human cognition is still the primary agent of change. That realm of warfare prevailed throughout most of human history, but collapsed at Lepanto in 1571. Thereafter, warfare took place in a second realm, the “human-machine” realm in which people became more deeply integrated with their weaponry. For the next several centuries, a slew of inventions helped expand the battlefield beneath the oceans, amongst the clouds, and even into space. And finally, Dr. Hagerott shared his belief that we are now entering a third realm of warfare: “autonomous machine.” In this realm, humans may yet surrender the execution of war to artificial intelligence.

Following their presentations, Dr. Greene and Dr. Hagerott engaged the audience in a robust discussion covering a wide variety of topics. Among other things, Dr. Greene affirmed that technological development did not guarantee actual progress, citing the inefficient Epic software that burdens hospitals across the nation (including the hospital at Johns Hopkins, where he currently serves as physician). Meanwhile, Dr. Hagerott warned the audience that “technology is unbounded,” and that ethics and empathy are not barriers to technology. If we want to place checks on our technology, he explained, it will require deliberate intervention and sustained vigilance. In sum, the speakers agreed that we have entered a Brave New World, and that we yet retain some say in how that world takes shape.