7 ‘Expanse-ive’ Medical Devices

I’ve noted before how the magnetic boots in the “The Expanse” fascinate me, and the latest fourth season was packed full of more medical devices than ever before. Keeping with the quality of the show (yes, I’m a fan), they are so realistic, as a medical device designer I can’t help but imagine how they would actually work as a real design. So, if reading a technical analysis of sci-fi props is something you enjoy, I present the following without further ado!

*If you don’t want spoilers for the show or the books, turn back now!

1. Eye Scanner
This an all-in-one portable eye-scanner that Dr. Okoye uses to discover the green parasites infecting everyone’s eyes.

What’s accurate? It appears to be a blue coherent light scanner. OCT (optical coherence topography) is a very common diagnostic technique today. Not sure I’d choose to blast visible lasers right in someone’s eye, but it sure looks cool.

What’s plausible? OCT detects macroscopic features in the eye, such as ridges, nerves, and inflammation down to the micrometer level. Bacteria are up to one micrometer wide, so they would only appear as single pixels (or not at all) in a modern OCT system. (I suppose alien bacteria could be bigger or OCT resolution could be better in the future.)

What’s implausible? The human factors elements of this device simply wouldn’t work. They hold the device by hand a couple centimeters from the eye and wave it around to scan the whole eye. It’s highly implausible you could hold such a device steady enough to register the single, tiny bacterium. In earlier episodes, it is pressed against the head which actually seemed more reasonable, but in later episodes they’re freehanding it. Not realistic.

What I would change: A change in workflow to hold it firmly against the head and let it the light beam move around (as opposed to moving the whole device around) would make a lot more sense.

Final assessment: Plausible with some workflow adjustments. They need a better human factors team.

2. Regrowth Chambers
Imagine working on a ship whose crew loses so many phalanges that you need to keep phalange-growing bags around. Poor Amos…

What’s accurate? This technology doesn’t really exist, but seems reasonable for a sci-fi show.

What’s plausible? I can get behind it being the future and so we can regrow fingers. However, they complemented this game-changing technology with a little thin plastic bag, so you have to sit in the doctor’s chair the entire time. I’d have made it a rigid protective glove you can walk around wearing anywhere.

What’s implausible? The whole idea of slathering on some goop and setting the egg timer is very futuristic. I suppose with some stem cells and the right promotion drugs, this could work. Maybe one day soon!

Final assessment: Sure, why not.

3. Autodoc
I’m convinced this was written into the plot so they didn’t need any awkward doctors hanging around in the scenes. That being said, this thing is pretty awesome. It’s like a more realistic tricorder.

What’s accurate? There are plenty of automated diagnostic tools out there, the most obvious being blood pressure cuffs, which look exactly like this. Tricorders are still a work in progress, but getting them all together a couple hundred years from now seems reasonable enough.

What’s plausible? The idea of a fixed tricorder chair/sleeve is much more practical than a handheld one you wave around in front of someone. The sleeve style allows for a number of close-contact sensors and it presumably has needles as well.

What’s implausible? The biggest challenge is the variation from person to person. Perhaps it could calibrate itself on a healthy user, then keep that as a baseline moving forward. Then everyone might need to get barcode tattoos.

Final assessment: Besides being light years away from current technology, this seems like a realistic design. In reality, it would probably be a lot bulkier and slower.

4. Catheter Ablation Device
The autodoc can automatically diagnose and treat dozens of conditions. Then there’s this fancy technology with a super developed graphic interface, but still requires our hero to use it manually. Is this drama or reality?

What’s accurate? Lasers! These are actually already used for catheter ablation.

What’s plausible? Despite my comments above, current catheter ablation technologies have some sort of guidance system. Some do have a camera on the end, some use ultrasound or contrast X-ray to guide them. Most user interfaces don’t look like a video game, but if the user is a layperson, that could actually be a good idea, similar to using an Xbox controller.

What’s implausible? The camera angle was unrealistically nice and the operator found the location pretty fast. In reality, it takes an expert to even know what’s going on with these things. As mentioned, the idea that the system would be smart enough to highlight trouble spots but not smart enough to shoot them itself doesn’t really make sense, but that’s not impossible.

Final assessment: Generally pretty realistic, but with some overt dramatization.

5. Saline/Plasma Tubes
A bunch of glass vials of saline or plasma are kept in the medical bay, nicely lined up on the wall for an emergency. Don’t bump into them!

What’s accurate? People certainly do need fluids. Having them handy makes sense. The transparent container is also pretty typical—then you can see what’s in it.

What’s plausible? It’s on the other side of the room, which feels unnecessary but not impossible. They also appear to be a little over-engineered, which goes against aerospace design rule #1 (the lighter the better), but I suppose it is a military warship.

What’s implausible? Fluids come in bags. Bags are lighter and perfectly strong—even shatter proof)—but they don’t need to deal with back pressure. As the fluid empties, the bag simply deflates. If it ain’t broke, don’t fix it.

Final assessment: the industrial designers got a little carried away on this one.

6. Knee Brace
I wanted this one to be more futuristic—it needed manual adjustment with a screw driver? Come on people, where are the frictionless bearings and the lasers?

What’s accurate? This could be on the market today.

What’s plausible? It seems to auto-adjust to the user to some degree. That could be a neat design feature to ensure comfort and support.

What’s implausible? Again, the fact that it’s super fancy but still has a manual adjustment screw seems unlikely, but not impossible.

Final assessment: Maybe too feature-heavy for frontier equipment (is the blue light really necessary?), but certainly plausible.

7. Self-Eye-Sampling Needle
The user just goes ahead and jams it into his own eye. Gross.

What’s accurate? The camera zoom is helpful and presented in a reasonable manner.

What’s plausible? This whole idea is plausible; it’s basically a needle with a visual guide. Why they thought they would need this particular piece of sampling equipment instead of bringing more food into their bunker is beyond me, but it certainly worked out!

What’s implausible? Why does the needle telescopically extend? Maybe to prevent needle stick injuries or keep it sterile, but probably just because it looks cool.

Final assessment: Perhaps the most realistic of the whole group!

The lab equipment was also cool, but not worth discussing. It’s mostly boxes on benches, after all. Some of the particular details were kind of laughable, but a good plot needs drama! Overall, the medical devices were pretty cool to think about, and fairly realistic for a sci-fi show. I hope you enjoyed this light-hearted review. I love that medical devices are actually a feature of this show—I’m looking forward to what season five has in store!