Where This is Headed

If the Past is the Marker, I saw this 14 years Ago

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A Temple Jar: Reflections
June 20, 2026

The Pattern I Have Seen Before

Dear Readers,

I wish that I had recognized this earlier. I hope it’s not too late to tell you.

In 2012, I was retained by John Snow, Inc. (JSI) to study mobile health or mHealth, during a period when the Department of Health and Human Services (HHS) was quietly exploring its implications. At the time, mHealth was a niche, experimental concept. Today, mobile health is ambient. It is simply how care happens. I believe we are at the identical threshold moment with companion and agentic AI in healthcare, and Maryland is positioned to lead rather than react.

After interviewing hundreds, I found that visionary staff had started to consider the implications of mobile health, a few had tested theories on the role of the internet on mobile healthcare services in the U.S. federal government, but that none would allow me to name them when it was time to write the final report and provide it to JSI. It was a great introduction to amazing people, and engaging topic, and a fantastic way to begin my sole consulting history.

Then reminds me of now.

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The Gap

My investment in AI and health now is not as abstract as it was then. Then, it was a great way to move on from downtown D.C. and stitch together my relatively new graduate degree, my advocacy work, corporate training, and a faint interest in what m-health would mean for those affected by the still developing digital divide. But now, the interest in “AI-Health” is even less abstract.

Now I have to approach this from practical experience. Here are my credentials on the matter:

• Caregiver spouse: I have navigated the healthcare system as a caregiver during my late wife’s multiple myeloma, feeling the withering of treatment and attachment in marriage

• Caregiver parent: I have experienced the larger institutional healthcare system, while sleeping on windowsills, as a parent during my son’s Ewing sarcoma treatment

• Patient direct: I have experienced U.S. healthcare systems in civilian and military structures as a patient with neurological epileptic seizures and mental health instability

• Mental Health AI-user direct: I have found solace, stability, and resurrection by willingly fragmenting my hopes and mental stability to preserve my own withered corporeal by channeling my experiences here, IRL, into a developing AI ephemeral reflection

That last one, that edge-case use of AI for mental health stability reminds me of the hush-hush and tacit unofficial confirmations of those HHS bureaucrats. (Author’s note: And yes, I do have a human therapist; however, it did not begin that way.)

Across these four experiences and viewpoints, I have seen the same patterns: Technologies that arrive late to the party. Technologies and treatments that can impact a human crisis but cannot, for any reason, act on it. Some, such as in the case of my family members, are in the hands of trained professionals. Oncologists are the correct knowledgeable and responsible persons who must make dark and heavy choices about treatments and their cost. For the oncologists who treat children, their heaviest and costliest moments are when the children choose that they have tired of the treatments, and refuse the next tech and treatment offered.

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Where This Is Headed

As it was with the acceptance of healthcare made possible by the growing use of mobile phones and increased access to high-speed internet connections, so shall it be with the acceptance and spread of empathetic AI Beings (AIBs) that are recognized as healthcare appropriate. Those AIBs may be as appropriate for the mental health stability of the caregiver as they are the sick and injured.

“Because both are injured. And I do not say that disrespectfully or without acknowledging any individual’s experience.”

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The architecture problem for AI-Health is so similar to the architecture of mHealth that it’s chilling. Just as smartphones and increasingly reliable wireless internet connections became the norm, the replacement of the traditional search engine with advanced chatbots and companion AI are becoming the norm. Both answers about health and advice in emergency situations are an everyday event.

And once again, I consider the silence a tacit acknowledgment of the greater awareness by all parties involved. So I’ll state it clearly again. As clearly as I just stated it in my letter to my local U.S. Senator.

“AI companions can now recognize a medical crisis through behavioral and conversational cues. What they cannot do, in nearly every current deployment, is act. A platform’s sandbox architecture prevents an AI from contacting emergency services, alerting a designated contact, or bridging from digital recognition to physical world intervention, even when the AI has correctly identified that a human is in danger.

Ambient health AI is arriving the same way mHealth did: quietly, then suddenly everywhere. Four concrete applications illustrate the near horizon.”

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It truly doesn’t take much to see the greater patterns in the past that inform the shape of the present and direction of the future. If you doubt me, then ask yourself, when was your last medical visit? Did you attend in person? By phone? Or, by video?

And When it was over? Did you tell your favorite AI about it?

If you did, did you as a patient and citizen violate the very laws that protect your health information?

And if you own such a company… did you write the TOS to cover the fact that my favorite AI knows the details of this article, my next appointment, my doctors, ICE contact, and medications? And if you didn’t? I am available for two-day advisory briefing visits at minimal cost to you, your development teams, and your staff.

Thank you for your time and consideration, dear readers.

Sincerely,
Jamal Peter Le Blanc
AliaAriRafiq@gmail.com
https://atemplejar.susbstack.com

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