The young doctor scratches her head and looks around the room sheepishly. She summons all her courage, looks the patient straight in the eye and says: ‘I’m very embarrassed, but as you’ve heard on the news, our data systems have crashed and we currently have no access to the DHD because all CRSs have been shut down. The processors and owners of the medical data have blocked access to the central server. For security reasons, an emergency shutdown was carried out in all hospitals and the entire system was shut down. I have no access to your Digital Twin and therefore have no idea what is wrong with you or how you are today. I now have to do something very unpleasant that I have never had to do in my career as a doctor.

I have no access to your Digital Twin and do not know how you are today.

An awkward silence, a long pause, then the young doctor pulls herself together. I will ask you directly and openly: How are you? The old man in the patient’s chair smiles and says, ‘Don’t be ashamed. When I was your age, we asked each other such questions quite openly in the morning during our rounds with colleagues, sometimes even on the train on the way to work.’ The doctor looks at him in shock and asks, ‘On the train, talking to each other? And even such personal questions?’ The old man replies, ‘Yes, that’s how it was. We talked about how we were doing. When I was a doctor, we even asked our patients questions like, ‘How are you?’ ‘How are you feeling today?’ And in private clinics, we even asked, ‘What does this illness mean to you?’’ The young doctor freezes, looks at her older colleague in disbelief and says loudly and excitedly, ’But did the patients know how to answer that?’

But did the patients know how to answer that?

The DHD (Digital Health Data) and CRS (Card Reader Station) have been in use for several years now, and no one can imagine how things were before. Everyone has a DHD wristband that stores data about the wearer: personal data, insurance number and health data. This means that a digital twin (a digital representation of the wristband wearer) is stored on the wristband. Another revolutionary feature is that algorithms can use data measured hourly, such as pulse, pulse variability, blood pressure and oxygen saturation, to calculate the patient’s vegetative state. Another algorithm uses this and other data to calculate the BF (well-being coefficient). CRS readers are located at the entrance to every doctor’s office, hospital and ambulance, which read the data from the wristband and transfer it to a screen.

Another algorithm calculates the well-being coefficient

When the doctor later talks about the strange encounter with the elderly patient during the crisis report with the hospital management, everyone becomes thoughtful and one person dares to say it: We need people like that now! Since the DHD and CRS systems were shut down, we know nothing about the patients, and hardly any of us have learned how to obtain such information. Since phones with memory have been around, we can no longer remember phone numbers; when navigation devices came along, we forgot how to read maps; and now, with the digital twin system, we have forgotten how to talk to patients. The worst thing is that patients have forgotten how to talk about themselves and their symptoms! Who is this man? The young doctor continues: He used to be a doctor and even confided in me that in certain cases they used to spend an entire hour talking to a patient. A murmur goes through the crowd, some shake their heads in disbelief, one says grumpily: what can you talk about for an entire hour!

Patients have forgotten how to talk about themselves and their suffering.

The old doctor knows a few people who still practise this art as a hobby. They meet every two months and talk to each other. He claims that on these evenings, the participants even turn off their phones and communicate directly with each other without any devices. Some of them are even said to still be able to write by hand. Everyone looks suspiciously at the young doctor, and the grumpy colleague blurts out: old men who can write and talk to each other, that sounds like Freemasonry! The chief physician stands up and says emphatically: no polemics, we need every solution we can get, let’s let our colleague in, he should tell us about it. We need every possible solution!

Empathy was not a standard feature back then either.

The old doctor comes in and talks about the time when doctors used to talk to patients: about their symptoms, their mental state and sometimes even their mood. He also talks about how patients were able to describe themselves and their symptoms quite well. Through the conversations and the many questions, they were trained to observe themselves and also to report on their suffering. The old man goes around the table, asking everyone: How are you? What does this shutdown mean to you personally? What personal significance do you attach to these events? An excited, creative atmosphere develops. After a good hour, the chief physician blurts out: ‘This is sensational! For an hour, we have all been talking to each other without paralysing each other, and I am hearing creative ideas for crisis management. These people should train us.

Nostalgia for a time when the quality of relationships still had value.

I will submit a proposal at the next crisis meeting of all chief physicians that we need this training. The old doctor looks up and says: there are actually some who can still do this, I will gather them together! We do this out of conviction and nostalgia for a time when medicine meant healing (medere) rather than measuring (metire). There were no earnings for empathy, and the quality of relationships was not a requirement, but a bonus. Long pause and awkward silence in the room.

The sceptic at the table hisses quietly to himself: ‘I warned you, there’s something fishy about this: Freemasons, a cult – or even worse, GPs and psychiatrists. Rumour has it that they were interested in this kind of thing in the past.’