I sat down one evening recently to relax and watch a favorite political sci-fi thriller on TV, as I do each week in part to unplug from the diabetes world for a bit. You know, as much as you can when you're connected to diabetes devices all the time.
What I wasn't expecting was for Person of Interest on CBS to hack into my down time, bringing diabetes into the picture from the very first minutes of the Dec. 16 episode.
If you're not familiar with the show, it's basically about super-smart artificially-intelligent machines that can access pretty much all information anywhere on the grid and make decisions based on that data. Four seasons in, the "good vs. evil machine" storyline is well-established: the former is helping to save people while the latter, uber-powerful machine wreaking havoc on the human world in hopes of conquering all. The all-star cast includes Jim Caviezel, Michael Emerson, Sarah Shahi, and Amy Acker, among others. I've been a fan since season one.
In the most recent episode, the good and evil machines are battling each other and people are caught in the crossfire. To prove a point, the bad machine kills an innocent man walking down the street. And get this: the man happens to be someone with diabetes and the method of murder is hacking into his diabetes device and delivering him a deadly amount of insulin.
As Person of Interest showed it, the device appeared to be a fully functioning combination CGM (continuous glucose monitor) and insulin pump, and it looked remarkably similar to an OmniPod PDM (!), even displaying some accurate terms like basal, bolus and blood glucose. The show took some Hollywood liberties though, since a seamlessly integrated device with all the bells and whistles they showed obviously isn't available to patients yet.
But WHAT THE HECK?! Depicting murder by D-device hacking using a unit that looks strikingly like a unique and popular insulin pump brand? What kind of fallout does that have in our community? Among D-parents? And among the public at large watching this?
Here's a look at the make-believe device as seen on Person of Interest:
Compared to the actual OmniPod PDM (and similar-looking updated model):
Of course, in typical dramatic TV style, the simple facts of how the scene played out were not accurate -- the man died immediately after getting that overdose of insulin, which couldn't have been more than the minute or two it took him to walk across a New York City street. Holy ultimate ultra-fast insulin, Batman!
Naturally, we wondered if Insulet was aware of this episode or had any comment... If they were not aware, it seems this could be grounds for a lawsuit over depicting their medical device as a dangerously easy target for tampering. After all, the unit in the TV show looks pretty much identical to an OmniPod!
When queried, authorities at Insulet indicated they were not notified in advance that this TV episode would feature a product so similar to the Pod PDM. Insulet President and CEO Patrick Sullivan provided only a general statement re: cyber-security that echoes how other insulin pump companies have responded in the past to publicized hacking claims:
"The OmniPod has several features that increase its level of security and safety. Both the Pod and PDM have redundant safety features that control and monitor for the integrity of wireless communications, program consistency, and user settings. The OmniPod system is extremely safe and to our knowledge, no instance of accidental or intentional control of Pod insulin delivery by an unauthorized device has occurred."
In some sense, I wish that what Person of Interest portrayed were more real. Wait, now hear me out!
The device in the show seemed to have a detailed insulin calculator and automatic dosing, but in reality, that's not something the FDA has even figured out how it wants to address yet. In fact, the regulatory agency just closed out public comment on a docket covering that issue in the past month. And then there's the obviously lightening-fast insulin that the man had in his pump. Many in our community have long wished that our insulin would kick in more quickly. Faster insulins are in the works, but nowhere near reality yet.
It seemed like the POI writers knew what they were doing, to some extent at least -- they got the right idea of what diabetes technology should accomplish, and how too much insulin is bad, which is more than we can say for other media outlets in the past. And the fact that they did enough homework to use real terms like "basal" and "bolus" and show the man taking a correction dose for a 186 mg/dL says something. And heck, the look of the fictional device they chose was all too real.
The notion of TV, movies, and media getting diabetes wrong (or stretching the truth to fit their storylines) is nothing new. It happens all the time, and we've written about it at length in just the past year or two. And our D-Community always has plenty of responses.
The fundamental question is: how realistic is the D-device hacking scenario?
As it stands now, at the close of 2014, the possibility of this happening in real life seems tiny, given where we are with diabetes tech.
But it's the future that concerns me. It seems we are quickly moving toward a point in time where this could very well become a real threat.
Seriously, I tuned into this episode just as all the news was breaking about the Sony hack, painting a bleak picture about the kind of world we live in and how dangerous the intersection of information and technology can be. We've seen other major security breaches, from confidential informant names or witness protection lists being released to the Target and Home Depot hacks into customer databases.
Meanwhile, in our D-Community, we're continually pushing for smart tech that closes the loop and allows our devices to talk with each other and store all our data in the cloud. (And yes, I am more tuned into that CGM in the Cloud conversation these days since I got hooked up myself.)
Obviously, the more we depend on automated devices and personal databases to manage our health, the more vulnerable we are to cracks in that system. Yikes!
This is the point at which my sci-fi fandom butts up against my real-world concerns that my D-tech could be sabotaged in some way. As much as I want this intelligent D-tech that automatically knows my blood sugar, calculates and doses insulin or glucagon, and "keeps me healthy"... I am worried about crossing a line into a place where we've truly surrendered control of our privacy and mastery of these devices.
Could it go terribly wrong? Hopefully not. But perhaps a little paranoia is a healthy thing, to keep us smart and cautious as we develop these high-tech tools.