Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St. Pomona, CA

Ode to the iPad

Recently, we've heard about the release of the newest iteration of the iPhone, the iPhone 5. This was apparently such a hot item that people were standing in long lines overnight at certain Apple stores around the country waiting to purchase their new devices. Personally, I'll never be one of those people. First of all, I can wait a few weeks to purchase any new item. Second, I've never been the earliest adopter of computer hardware and software for the simple reason that the first version of anything usually has problems and needs "fixing".

Having said that, I divulge that I am the proud owner of both an iPhone and an iPad. After watching my wife use her's (she owned both long before I did), I finally broke down about a year or so ago and purchased my own iPad. The iPhone shortly followed after my Droid cell phone stopped functioning in a predictable manner. After agonizing over what kind of tablet I'd buy, I finally came to the conclusion that the iPad would be best for me.

"Why write about this now, Shapiro, after a year" you ask? By now, it seems almost everyone owns something like one of these devices, and most of us are at least familiar with their use. But I had a quite interesting encounter last week with a patient that added both perspective and appreciation for these devices.

I was seeing a new patient accompanied by his wife with a complaint of chronically in-growing hallux nails. This was a very nice older gentleman with the very unfortunate diagnosis of amyotrophic lateral sclerosis (ALS), AKA Lou Gehrig's disease. Many of you will recall this as the disease suffered by Stephen Hawking, the famous theoretical physicist. Luckily, my patient wasn't affected quite as badly as Dr. Hawking – we was still able to move his arms. Otherwise, all fine motor functions, including the use of his facial muscles, had ceased. As a result, his wife was doing much of the verbal communicating with me. We talked for some time, and I recommended a matricectomy.

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All of a sudden, I heard a computer voice coming from my patient asking a question. For about 1 second I missed the question, not expecting this, and then realized the patient had an iPad in his lap and had used this to communicate with me! As it turns out, the patient was using an application called Verbally+ which provided him the iPad keyboard. He typed out his message and the iPad spoke what he typed. This is similar, in a much lower-tech version, to what Stephen Hawking uses to communicate, although that device apparently uses optical scanning to allow him to type. The patient's wife explained to me that her husband, in fact, had the same technology as Dr. Hawking at home, but it was much more difficult to travel with, since it had a large computer box that had to be mounted on the wheelchair. As such, the iPad's Verbally+ was an excellent substitute while out and about.

I was very impressed with this technology, not in the sense that the program was anything amazing in itself. It was simply a keyboard that "spoke" what was typed into it. Compared to other technology, that's just not surprising. What impressed me, I think, was the reminder of what common technology like the iPad could accomplish for patients. Very simply, my patient's iPad empowered him to interact with the world in a way that would have been impossible less than a couple of decades ago. Can you imagine what it must be like for this man? His mind is fully functional, while his body simply stops functioning. He's trapped in there. Without his iPad, his wife would be forced to lug a large device around with them, severely limiting both of their freedoms. This device that I take for granted (heck, I let my son play video games on mine – yes it's an awesome babysitter in the car on long trips) freed my patient to live his life to a much greater extent. What a gift.

I was going to talk about some of the other ways I use my iPad for medical education, work, and other things, but when you put it in perspective, what better ode to the iPad can there be but to consider its incredible benefit to our patients. If it can give some freedom to my ALS patient, imagine what else it will do in the future. Thank you iPad.