How extensive is medical technology in the 23rd Century UFP?

[Chaos Descending]

Like, what kinds of medical problems do people still suffer with today that are considered ancient problems by the 23rd Century?

We know that Dr. McCoy was able to cure a woman's end-stage renal failure with just a pill. (STIV:TVH)
We know that arteries in the brain can be repaired without opening the skull. (STIV:TVH)
We know that lung cancer was "easily cured" by the mid 22nd Century (Per Dr. Phlox in ST:E).

I assume that by the use of transporter bio-filters, virtually every bacterial, fungal, or viral infection can be erased.

What about spinal cord problems? Can they quickly, effectively, and reliably regenerate nerves in the 23rd century?

Is diabetes a thing of the past? Diabetic (or other forms) of neuropathy?

ALS? Alzheimer's? Parkinson's?

I wonder about these things sometimes. I think most people fixate on all the cool stuff: phasers, warp drives, shields, and transporters. I wonder about the stuff that would improve the human condition holistically.

 

[NCC-73515]

What about spinal cord problems? Can they quickly, effectively, and reliably regenerate nerves in the 23rd century?

Worf only recovered because of a new and risky replacement method 100 years later, so I think they couldn't do anything about that in the 23rd century. Might depend on how severe it is, of course.

 

[Chaos Descending]

I suppose there wasn't really a coherent view of what medical technology was like in the Star Trek universe.

Then again it might also be because Worf is a Klingon.

 

[NCC-73515]

True, Bones didn't even know Klingon anatomy at the end of his career XD

 

[Deks]

Worf only recovered because of a new and risky replacement method 100 years later, so I think they couldn't do anything about that in the 23rd century. Might depend on how severe it is, of course.

To be fair, we already knew about stem-cells and tissue regeneration potential by the time that episode aired in real life (season 5 of TNG, episode 16 - this was February 1992).

I always found Worf's injury and lack of treatment to be... stupid... especially when they were able to regenerate tissue damage from practically every other problem already.
That and the fact that UFP seems to NOT be using stem-cell regenerative therapies in medical treatments at all - especially since we were able to do it relatively recently:
https://news.yale.edu/2021/02/22/ya...ed-spinal-cords-using-patients-own-stem-cells

As you may have noticed... McCoy treating that old woman in a hospital with a simple pill...well, he was able to repair her kidney in a short amount of time (and its possible you wouldn't see this in the TOS series because they might not have thought about it - but in such cases, they should probably just say a problem was dealt with without going into too much detail until they can potentially get a consult to help them explain it at a later date should they decide to revisit the issue).

So, given the extensive damage UFP could repair and could probably fashion new organs using bio-printing (as opposed to using prosthetics - unless they are preferred), Worf's injury never made sense to me.

 

[Chaos Descending]

True, works of fiction with multiple creative individuals and teams are sometimes going to be internally inconsistent.

 

[Unimatrix Q]

Considering that Culber was up to date relatively quickly after the Discovery arrived in the 32nd century and that there was still no way to revive and save the Barzans on the Tikhov, i guess medical science didn't advance very much since the 23rd/24th century.

 

[Deks]

Considering that Culber was up to date relatively quickly after the Discovery arrived in the 32nd century and that there was still no way to revive and save the Barzans on the Tikhov, i guess medical science didn't advance very much since the 23rd/24th century.

Not really.
When Discovery arrived to retrieve the samples, they were new to the 32nd century. No refit, no database updates, no technology updates, nothing. The crew was simply debriefed and then when UFP confirmed their identities, Disco immediately went to help them retrieve seeds from Tikhov.
So, Culber (as far as I know), still worked with 23rd century knowledge and technology for that one mission.

The whole EMC issue never made sense.
An EMC would have showed up on sensors (which are FTL) long before it would have hit the Tikhov (which would have allowed the computer to do a minor Warp jump to a safe distance)... at the very least the computer would have automatically raised the shields to prevent the radiation from affecting the crew.
But, at the time of watching the episode, I thought that shields for this (and a number of other stellar phenomena) simply wouldn't be necessary because the hull would be comprised of alloys that would be impervious to most of them anyway in the 32nd century (based on what the UFP already knew from even late 24th century and WITHOUT temporal technology).

The writers have made quite a lot of 'plot holes' here which don't make any sense for the setting... except for the purpose of generating drama.

Also, in the 32nd century, majority of medical procedures would have likely been doable in the field without needing a surgical bay or going back onto a starship in the first place.
We've seen that transporters can de-age people already in the 24th century... and I find it unlikely UFP wouldn't have made massive advancements in medicine either... plus in the case of a medical emergency, where was the Barzan family supposed to have go to for help?

There had to have been either a medical bot (or several) on board along with holograms which could perform surgeries and would immediately respond in case the lifesigns are no longer detectable or an event like EMC was expected (similar to what we saw on the Earth sleeper ship that carried Gray and Adira which was hit by a stray asteroid - I'm still not good with that random asteroid slamming into the ship like that because even technology from the 24th century would have avoided that problem).

Plus, the family was dead for weeks before Discovery arrived to the scene, so I don't think Culber could have done anything... maybe an upgraded Disco with contemporary 32nd century tech might have... but again, given the extensive use of automation in the 32nd century and programmable matter, I suspect medical procedures would have been done instantly using programmable matter/nanotechnology and portable transporters most likely.

 

[trekshark]

Alzheimer's
replaced by Irumodic Syndrome

 

[dupersuper]

Enterprise mentioned a protective covering of some kind people get on their teeth (just ignore all the actors with visible fillings when they scream).

 

[Unimatrix Q]

Not really.
When Discovery arrived to retrieve the samples, they were new to the 32nd century. No refit, no database updates, no technology updates, nothing. The crew was simply debriefed and then when UFP confirmed their identities, Disco immediately went to help them retrieve seeds from Tikhov.
So, Culber (as far as I know), still worked with 23rd century knowledge and technology for that one mission.

The whole EMC issue never made sense.
An EMC would have showed up on sensors (which are FTL) long before it would have hit the Tikhov (which would have allowed the computer to do a minor Warp jump to a safe distance)... at the very least the computer would have automatically raised the shields to prevent the radiation from affecting the crew.
But, at the time of watching the episode, I thought that shields for this (and a number of other stellar phenomena) simply wouldn't be necessary because the hull would be comprised of alloys that would be impervious to most of them anyway in the 32nd century (based on what the UFP already knew from even late 24th century and WITHOUT temporal technology).

The writers have made quite a lot of 'plot holes' here which don't make any sense for the setting... except for the purpose of generating drama.

Also, in the 32nd century, majority of medical procedures would have likely been doable in the field without needing a surgical bay or going back onto a starship in the first place.
We've seen that transporters can de-age people already in the 24th century... and I find it unlikely UFP wouldn't have made massive advancements in medicine either... plus in the case of a medical emergency, where was the Barzan family supposed to have go to for help?

There had to have been either a medical bot (or several) on board along with holograms which could perform surgeries and would immediately respond in case the lifesigns are no longer detectable or an event like EMC was expected (similar to what we saw on the Earth sleeper ship that carried Gray and Adira which was hit by a stray asteroid - I'm still not good with that random asteroid slamming into the ship like that because even technology from the 24th century would have avoided that problem).

Plus, the family was dead for weeks before Discovery arrived to the scene, so I don't think Culber could have done anything... maybe an upgraded Disco with contemporary 32nd century tech might have... but again, given the extensive use of automation in the 32nd century and programmable matter, I suspect medical procedures would have been done instantly using programmable matter/nanotechnology and portable transporters most likely.

Good points. But i didn't want to imply that Culber knew all about the possibilities of 32nd century medicine when the away team encountered the barzan family, although i wonder why he didn't ask Lieutenant Willa and the other visitor from Starfleet command about the options, but that he apparently already was very knowledgeable about it after just a few episodes.

As seen when he tried to treat Emperor Georgiou.

 

[matthunter]

The mention of the Federation not using stem cells is interesting, but how do we KNOW they aren't? That pill McCoy gave the old lady may have been a targeted CRISPR to trigger her own stem cells to repair her kidneys, then revert to normal function once done.

As for Worf, it may be that the redundancy built into Klingon biology actually works against them in some cases? A human spine and nervous system might be an easier repair even though it's more vulnerable normally (the more they overtake the plumbing....). I'm minded of a detail in an RPG sourcebook on Andorians which stated that Andorian "bone" is actually a blend of bone and chitin (going with the "antennae = insectoid" notion) and thus it takes much more effort to break an Andorian's bones than it does a human, but conversely such a break will never be "clean" and will be harder to repair.

 

[Deks]

Good points. But i didn't want to imply that Culber knew all about the possibilities of 32nd century medicine when the away team encountered the barzan family, although i wonder why he didn't ask Lieutenant Willa and the other visitor from Starfleet command about the options, but that he apparently already was very knowledgeable about it after just a few episodes.

As seen when he tried to treat Emperor Georgiou.

Culber tried treating Georgeou several episodes after that one... weeks after Discovery received its refit and technology upgrades and Culber had access to contemporary medical technology and knowledge (but, with him being human, it would be impossible for him to absorb most of the contemporary knowledge that fast... it would be a learning curve over time - unless UFP HQ had technology which would transfer the knowledge to his brain instantly with say a neural transceiver - but we don't know if they would be using that technology for that).

When Disco went to the USS Tikhov, they did so as their 23rd century stock ship/tech/knowledge.
Culber simply speaking had no opportunity to look into medical advancements which took place between his arrival and debrief at UFP HQ and by the time they got to the Tikhov.

 

[Deks]

The mention of the Federation not using stem cells is interesting, but how do we KNOW they aren't? That pill McCoy gave the old lady may have been a targeted CRISPR to trigger her own stem cells to repair her kidneys, then revert to normal function once done.

I'm aware of that... but if that was the case, it probably would have been mentioned by then.
We don't know what exactly McCoy gave her. Could have been nanotechnology for organ repair which would have effectively degrade harmlessly into the body once its job was complete.

As for Worf, it may be that the redundancy built into Klingon biology actually works against them in some cases? A human spine and nervous system might be an easier repair even though it's more vulnerable normally (the more they overtake the plumbing....). I'm minded of a detail in an RPG sourcebook on Andorians which stated that Andorian "bone" is actually a blend of bone and chitin (going with the "antennae = insectoid" notion) and thus it takes much more effort to break an Andorian's bones than it does a human, but conversely such a break will never be "clean" and will be harder to repair.

I don't think that's the case... if it were, then his redundancy would have worked against him effectively when they applied the treatment in the show.

I think the problem was rooted in lack of medical knowledge of Klingon anatomy... which I think was mentioned in the show and Crusher (and whats her name) had to effectively map it themselves.

But this again makes little sense when you basically have at your disposal ridiculously advanced medical technology with sensors capable of scanning down to the subatomic and computers capable of real-time accuracy and excessively fast extrapolations and R&D... not to mention 200 years worth of medical data from 150 different species that joined UFP and dozens/hundreds of others they may have encountered while exploring.

The dataset UFP would have acquired from its member species alone (not counting the Klingons) would probably give computers ridiculous amount of data points so it can predict with 99.9999% accuracy what each Klingon organ does.

Plus with UFP and Klingons being allies and Worf effectively growing up in UFP, he would have been a live Klingon specimen on which the UFP would need to have some kind of medical history - even if it was a yearly physical from when he was growing up... certainly more than enough to treat him effectively at some point in the future because the doctors would have scanned him every year at least once and could easily compare data sets on a maturation of a Klingon male from adolescence into adulthood and figured it out by themselves.

See, to me, that kinda says the writers just didn't think many things through...

 

[Unimatrix Q]

Culber tried treating Georgeou several episodes after that one... weeks after Discovery received its refit and technology upgrades and Culber had access to contemporary medical technology and knowledge (but, with him being human, it would be impossible for him to absorb most of the contemporary knowledge that fast... it would be a learning curve over time - unless UFP HQ had technology which would transfer the knowledge to his brain instantly with say a neural transceiver - but we don't know if they would be using that technology for that).

When Disco went to the USS Tikhov, they did so as their 23rd century stock ship/tech/knowledge.
Culber simply speaking had no opportunity to look into medical advancements which took place between his arrival and debrief at UFP HQ and by the time they got to the Tikhov.

But wouldn't Willa and the other 32nd century starfleet member have mentioned some possible cures for the radiation sickness or a way to bring the Barzans back to life, if medicine really made some big advances over all these centuries? Especially as they still died because of the radiation and were most likely frozen shortly after their death.

Considering the medical background of Discovery's mission in this episode, i can't imagine that these two officers didn't have at least some basic knowledge of 32nd century medicine...

 

[Deks]

But wouldn't Willa and the other 32nd century starfleet member have mentioned some possible cures for the radiation sickness or a way to bring the Barzans back to life, if medicine really made some big advances over all these centuries? Especially as they still died because of the radiation and were most likely frozen shortly after their death.

Considering the medical background of Discovery's mission in this episode, i can't imagine that these two officers didn't have at least some basic knowledge of 32nd century medicine...

Willa was (from what we saw) a security officer.
Her knowledge of medical matters would have been limited to non-existent at best and as such she wouldn't know the extent of which 32nd century medicine is capable of (though to be fair, I would expect of each SF officer to be exposed to relevant general education... which WOULD technically include some minimal knowledge of medical science capabilities even if it comes to bare bone basics - but again, without her being a medical doctor and given the kind of specializations we saw in Trek, it usually means that a head of security would know virtually nothing about medical science - certainly not when it comes to offering potential treatment options).

You saw in the same episode when Stamets, Tilly and Reno worked to unravel the mystery of what happened to the Tikhov, Willa was was standing there clueless about the overall science... even though I would have thought she would at least have some 'minimal' understanding of the subject matter.

Also, Discovery had no idea of the situation that would have awaited them at the Tikhov... otherwise, Federation HQ would have likely dispatched a doctor with them who is up to date with 32nd century medicine.

And while I agree that putting people in suspended animation shortly after death could have potentially preserved them for later resuscitation, its possible the EMC caused such damage to the extent where death would have been instantaneous and may have damaged the cells well beyond repair.
We saw that physical injury resulted in death of Gray after all... even though I would have fully expected medical science of 32nd century to be able to repair it all.
But hey... drama.