Medical Holograms

Since the early 2370's, many Starfleet ships have been equipped with emergency medical holograms - computer-generated holographic doctors that can perform all the duties of a real physician.  The program is installed in a starship's sickbay, and can be activated during a medical emergency if the medical staff are unavailable or incapacitated, or if additional help is needed.  The primary developer of the first medical hologram, designed the Emergency Medical Hologram AK-1, or EMH, was Dr. Lewis Zimmerman, a Jupiter Station technician working in Starfleet's Holoprogramming Center.  The development team also included Lt. Reginald Barclay, who tested the EMH's interpersonal skills.

In order to accommodate an EMH, a ship's sickbay has to be fitted with a sophisticated holographic system.  The EMH needs something more advanced that the holodeck's standard sensor systems to gather diagnostic information, and has to be able to manipulate objects precisely to perform surgery and work with other medical devices.  To meet these needs, the EMH developers modified holographic projectors so that they could maintain extremely accurate electromagnetic fields and wrote a tactile subroutine that gives the EMH a sense of touch.  The EMH is programmed with the Federation's entire medical database.  Its programming includes 50 million gigaquads of information spanning 3,000 cultures (including those that have psychospiritual healing beliefs), the personal experience of 47 physicians, 2,000 medical references, and five million possible treatments, all with contingency options.  Dr. Zimmerman formulated a highly adaptive multitronic pathway that endows the EMH with the ability to create additional subroutines as new situations are encountered.  This means that, if necessary, it can develop new treatments.

The EMH can perform with or without human input for an aggregate of 1,500 hours before failure.  But, as its name implies, it was only designed for short-term use.  The program's memory matrix is vulnerable; new adaptive routines will eventually cause the system to collapse, and it can be degraded by radiation.  After 1,500 hours of usage, protocols for the EMH demand a visit to a starbase for maintenance.  If this is not possible, the program can simply be reset.

The EMH is activated either by voice command or a red alert.  If activated by a red alert, the EMH immediately ties into the ship's key systems to ascertain the ship's status.  When the EMH appears, it says, "Please state the nature of the medical emergency."  When it is no longer needed, it should be deactivated by voice command.  The EMH was designed to look just like a normal person, but because it is a hologram it can control its density.  For example, an EMH can literally turn into thin air if someone tries to grab him.  The personality is the least developed part of the system - the EMH was designed to save lives, not to make friends.  It cannot feel pain, or cry, or bleed.  It was not given a name, but was programmed to respond to "Doctor."  The template for the medical hologram's body and personality is Dr. Zimmerman himself, and hence the EMH is male, balding, smug, cheerful, and caustic.  But, because of its adaptive routines, its personality can evolve if it is left active.

The EMH was programmed with genuine concern for his patients and reverence for the Hippocratic oath.  The program can even refuse a direct order if it violates the oath.  Dr. Zimmerman expects the original EMH program to be used for decades, but work has begun on the EMH Mark 2 (which is in the prototype stage) and on a new Long-term Medical Hologram, or LMH.  The second of these programs is intended for use on remote postings and is planned to run for months at a time.  Because the LMH will run for long periods, Dr. Zimmerman and his team have decided that it should have a more developed personality than its predecessor.  As he says, it must be able to "share amusing anecdotes, extended sympathy, swap dirty jokes, and even have culinary opinions, based on experience."  In order to achieve this, Dr. Zimmerman is devoting a considerable amount of energy to developing its personality subroutines.