Are we in the Overton Window for medical wearables? : Part-1

The medical wearable as the gateway to understanding of the self

Wearable technology – trackers, smart watches, health sensors and monitors are the chroniclers of our times, documenting our existential angst and triumphs as dispassionately, quietly and unassumingly as the proverbial fly on the wall. In this three part series, we explore the birth, the growth and the implications this tech enabled, inanimate yet intimate perspective wearables have on our lives, health and culture. We examine the doubt and hope they bring to the human experience and observe how their future rests on imbibing the core principles of meaningful design.

There’s an interesting episode in one of contemporary pop culture’s most beloved sitcoms, the Big Bang Theory. The nucleus of a group of academically brilliant, socially awkward misfits – theoretical physicist Sheldon Cooper, gets his mom to ship his childhood paraphernalia to him. In typical Sheldon fashion, he has a point to prove and hence needs the scientific notations and personal diaries he diligently maintained as a child prodigy. 

While randomly perusing the diaries, the only non geeky female character Penny, is left green faced when she discovers that young Sheldon had meticulously tracked the lurid details of his bowel movements to keep a tab on his gut health – a habit he faithfully continued into adulthood. The only difference being, he took this unsavory documentation a notch further through newer rituals; he would tape a bowel metrics chart to his refrigerator to remind him what to eat and share the analysis with his friends and family in his weekly email blasts.

Had Sheldon’s childhood, or even adulthood been set in the wearable tech era, he’d have an array of devices to choose from to delegate the unpalatable job of monitoring his gut. Take for instance, the pocket-sized device developed by healthtech startup FoodMarble in 2018 that allows one to track their digestion in real time.

The user enters what they’ve eaten into the app and then employs the device, called AIRE, as a breathalyzer, to determine if the food is friendly to their gut. The logic – hydrogen, detectable by the sensor in AIRE, is released in the breath when undigested food, that is malabsorbed by the small intestine ferments in the large intestine. The more one uses the app, the greater is one’s awareness about concurrent bodily functions which are affected by the gut – sleep, energy and stress, among others.

Thanks to micro innovations like these, over 100 million units of wearable devices – smartwatches, fitness trackers, hearables, smart clothing, sensors, monitors and diagnostics were shipped in the second quarter of 2022. Even as the numbers are rather formidable, they have fallen short of the anticipated sales figures, with the dip owing to fears of recession and the natural downward curve after a period of frenetic sales during the pandemic.   

What explains the global obsession with these tech consumables, which have become omnipresent symbols of self-care? For starters, smartphones today have turned into veritable lifelogs, silently documenting ordinary lives in minute details, sparking interest in things that were once too quotidien to ponder over. When coupled with the personal nature of a wearable, they have created an element of self-interest in health and wellness.

Before the smartwatch, did you care about your heart rate or the level of noise in your walking track? You now don’t have to be a doctor to know that you are at the risk of Tachycardia if your resting heart rate exceeds 100 beats per minute, or that you are a candidate for hearing loss if you regularly expose your ears to over 70 decibels of sound. Your smartwatch fires a warning when your body crosses optimal health limits.

This proposition of personal science, where non-experts now have the means to launch a scientific enquiry into their own health, was propounded by Gary Wolf and Kevin Kelly, former editors of The Wired Magazine, who founded the Quantified Self Movement (QS) in 2007. QS “supports every person’s right and ability to learn from their own data.” Learn how? By observing, experimenting and analyzing.

Though not a new phenomenon, QS achieved cult status simply because it harnessed the ability to gather actionable data through tech tools and use the findings as a mirror for self-knowledge. Adherents of the movement combine various dimensions of everyday experience and subject them to the critical scrutiny of scientific methodologies.

The data so generated, could also act as a self-regulator of human behavior, nudging us to more positive health outcomes by allowing us to pause, take note of inefficiencies and work on them. Our success or failure is quantified by the target we set, and tracking our effort to achieve it. 

The Quantified Self not only removed the sheen of esotericism from our understanding of our own mental and physical health, but also transformed self-search into a gregarious activity, where groups of people around the world with similar interests gathered in community meetings to discuss outcomes of their personal tracking projects and health experiments.

Today, there are community trials on using potassium for weight loss, identifying which type of grass aggravates one’s allergies and even whimsical ones, such as finding out what happens when one runs marathons on zero calories, or using data on running to dictate fashion choices.

Gary Wolf made this connection between wellness and tech-enabled self-acuity in his TEDTalk in 2010, when he first made the QS movement mainstream. “The self is our operation center, our moral compass, our consciousness. If we have to act more effectively in the world, we have to get to know ourselves better”, he had said.

What Wolf spoke about reflects thousands of years of philosophical pondering on self-knowledge. If one were to compress these observations in a simplistic, single line summation, it would probably read something like this – the primordial urge to know oneself is the deliberate act of building progressive awareness of the body, the known and unknown mental states.

Orchestrating harmony between these aspects, both in solitude and in the company of others, can be understood as an attempt to inch toward the desired equilibrium of ‘being healthy’. Even the World Health Organisation recognises health as the state of “complete physical, mental and social well being”. Without a modicum of self awareness, therefore, being healthy is little more than a pipe dream. 

The question of what constitutes the self, has always plagued the thinkers of every era. What has changed now, as compared to even a decade ago is the language, the medium and the agency through which we perform this intimate act of self discovery.

The metaphysical, the psychological and clinical looking glasses have given way to the technological lens – the wearable devices strapped on or injected within are constantly gathering information about our bodies and minds (It is rather serendipitous that the first ever medical wearable to be invented was a pair of eyeglasses in the 13th century).

Big Bang Theory’s Sheldon Cooper had no qualms about turning his indefatigable scientific curiosity inward, not even sparing his bodily functions from empirical scrutiny. He was flummoxed that his peers found his fascination abominable at worst, tiresome at best. With wearable tech, perhaps we can all channel our inner Sheldon, if not his erudition, at least his passion for science, to endlessly learning new things about ourselves.

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