Hypertension 1996 : One Medicine, Two Cultures
TRAINET PROJECT: a telematic link for medical cultures
L. Pucci
General chairman Of Trainet Spa – Stet Group
Telecom Italy, Rome
Ostia: Ancient Rome an the “Land of Silkers”
This conference is being held in Ostia. In the first century before Christ,
Ostia was the chief port of Rome. From here, ships set sail for the ports
of the Eastern Mediterranean and for Syria, the starting point of the trade
routes to India, which earlier still, in the second century BC, had received
Chiang Chien, the ambassador of the Emperor of China.
Thus trade between east and west actually originated in the ancient world.
The silk in which the Roman emperors were clothed came from china.
Non-communication between cultures: technological and political problems
Despite their commercial relations, Romans and Chinese were in contact
only through intermediaries. They scarcely knew each other. The whole of
the Latin literature offers but a handful of references to the culture and
philosophy of the “Silkers”, as the Romans called the Chinese; Chinese sources
are equally sparing in reports on Rome.
The fact is that the Roman and Chinese empires traded but did not communicate
with one another.
Two millennia later…
Obviously, things are quite different today. Since Marco Polo’s first
trip to the Orient around the turn of the 14th century, relations between
China and the west have steadily intensified. Intercourse has touched all
possible fields, from trade to art, from military affairs to basic scientific
research.
Yet we are all well aware that the two cultures remain far apart. Even today,
at the dawn of the 21st century, it is easier to trade than to communicate.
Trainet and “professional communication”
This conference has been made possible by systems and technology provided
by Telecom Italia for the express purpose of facilitating communication
between cultures.
My own company; Trainet, a member of the Telecom Group, is particularly
intrigued by this objective, as our specific mission is to state-of-the-art
technology to assist what we call “professional communication”, i.e. communication
between professionals.
My remarks today are thus intended to show what professional communication
could mean to the professional men and women gathered in this hall: a group
of physicians who are united by shared concern and objectives but nevertheless
separated by immense geographical and, sad to day, sometimes cultural distance
also.
Doctors and new technology
Physicians were among the first users of the new information technology.
Information technology has revolutionised your diagnostic, monitoring, therapeutical
and management techniques.
But these are not technologies I want to talk about today. Rather, I should
like to expound on the product that my own company deals with, namely technology
for communication.
This technology is often simpler and cheaper than modern hospital equipment,
but it may still contribute significantly to doctors’ professional work
by providing access to that most powerful of cultural tools, the exchange
of ideas.
The network revolution
You have all heard of the Internet. Many of you are certainly users,
often more expert than me.
Internet is the perfect multimedia instrument. It enables any network user
to exchange messages, texts, images or complex scientific data with other
user while simultaneously providing access to an immense mass of information
supplied free of charge by corporations, universities and individual users,
who themselves act as publishers by making their discoveries and ideas available
to the rest of the web.
This is the technological aspect of the revolution.
The economic side
More important than the technological aspect, however, is the economic
one. All it takes to link up with the Internet is local phone call. Subscribing
to a net server costs just $ 175 a year, not even half a dollar a day.
A single local call enables the subscriber to use the net for long they
wishes, exchanging an unlimited volume of messages over any distance or
accessing all the data available.
Today Internet users number perhaps 40 or 50 million, but the rate of growth
is 2 million new users a month (you heard me right: 2 million per month
not per year).
And that is the economics of the revolution.
Politics and culture
What does it mean from the political and cultural standpoint?
Up till the very recent past, only governments and large corporations had
the capability to communicate directly at the international level. But plunging
costs now open up this possibility to an ever-larger part of the population.
Thus whereas in the past knowledge of the other cultures was obtainable
only through the mass media, the Internet now offers, for the first time,
the possibility of direct contact, of checking at the source.
All this has revolutionary potential. In fact, some observers have in fact
likened the advent of the Internet, in impact, to that of the printing press.
Among the greatest beneficiaries of this revolution are professional people,
including doctors.
Doctors and network – information and discussion
Through Internet, any doctor – or any patient – can access the huge bibliographical
database that were once the exclusive preserve of the largest American medical
schools.
Through these databases, the doctor can obtain crucial information on the
latest techniques of diagnostic and treatment, epidemiological data, scientific
research, the results of clinical tests.
And alongside this information-in-the-raw there have sprung up “news groups”,
electronic conferences in which the participants discuss issues of common
interest.
Through news groups doctors can inform themselves of the most advanced stage
of cultural and scientific discussion and debate. Moreover, the network
is a marvellous tool in the interests of health service users – such as
HIV patients, whose associations have played a pioneering role in conveying
medical information to non-specialists.
The barriers
All this sounds beautiful, of course. Yet as I look around me, in many
faces I can read doubt and perplexity. Because so far I have spoken only
of the promise of the network, not of the obstacles to its utilisation:
real barriers that some of you have certainly encountered in practice.
The most important of these obstacles is neither technological nor economic,
not even political: they are cultural barriers.
The two cultures
Many years ago the English writer C.P. Snow analysed the split between
“two cultures”, the technical-scientific on the one hand and the humanistic
on the other.
Personally, what I see today is another emerging dichotomy, between the
users of the new technology, who are still a minority, and the great majority
of non users.
This dichotomy, however, is one that cuts across Snow’s two cultures. I
know professors of classics who routinely use E-mail in their work and eminent
engineers who refuse it.
A possible answer
If what I have just said is reasonable, then it is clear that the essential
first step in the application of the new technology is to bridge the gap
between users and non-users, by facilitating the latter’s access to the
possibilities that are opening up.
In the few minutes remaining to me, I would like to offer a practical scenario
showing how the network – and Trainet – could help.
Web style
The difficulties for potential Internet users can take the most commonplace
forms.
The network often requires an ability to use or at least understand English.
Internet has rules of its own governing modes of expression, intervention,
and response in a discussion: “netiquette”, the Internet code for acceptable
conduct.
Internet even has its own literary style. Style, etiquette and language
are among the network’s characteristic features; but for those who are not
familiar with them, they represent so many barriers to profitable use.
Lost in cyberspace
And that is not all.
To the initiated, the Internet is like an enormous library without a librarian
or even an official catalogue.
Like any self-respecting library’s, the Internet collection includes fundamental
works, but also a large amount of quite minor information. Even with the
aid of the most up-to-date tools, locating specific data is an arduous task.
The user finds him lost in cyberspace, catapulted into an utterly unfamiliar
world – like Marco Polo at the court of Kublai Khan.
Trainet’s proposal
And this is where Trainet comes in.
The purpose of Trainet is to act the network, transforming what may appears
as an inscrutable, hostile environment into a familiar and even comfortable
workplace for professionals.
The proposing is that instead of being thrown into the network without either
guide or life preserver our user is given a range of services that are accessible
via the Internet but that are “personalised” for their own special professional
needs.
To begin with, for example, we could create a Web site for this conference:
an “electronic location” where many of the Internet’s 40 million users could
read the conference proceedings, and in their own language, be it Italian,
English or Chinese.
And that would only be beginning. The site could also accommodate your articles,
letters, and research findings. We could create “pointers” to other sites
that are likely to be of interest to the users of ours.
Above all, though, the site would be designed as a space for discussion,
interchange and debate, with some areas for popularisation (activities intended
for a general audience as well as for physicians with other specialities)
and others for work at higher scientific levels.
And this would be available to end-users for just $ 175 a year.
A bridge to the future
In this scenario, which I hope is not too far in the future, Trainet
could make available its experience, its methodology, its technology. We
are already doing this in a major joint project together with Beijing Normal
University, so it would not be the first time that we have engineered an
encounter between different cultures.
We can design and built the “web site”.
We can publicise the site through Internet instruments.
We can handle the “broadcasting” of the participants’ scientific output,
see to the translation of informational material into other languages and
moderate conferences.
We can provide training and technical assistance to users who are experiencing
difficulties.
We can help facilitate your entry into the world of Internet.
Then, once a bit of our various cultures have been brought together and
shared, we might get in touch with one another more often, the better to
develop the kind of cultural and scientific interchange and relations that
form the real purpose of this conference.
For me, it would be a great honour if my company were allowed the opportunity
of accompanying you in this grand undertaking.
Edited by Aldo Campana,