It's easy to become fatalistic about the current state of technology. The great promises of each new technology - the nuclear technology of thirty years ago, the micro-processor revolution of the last decade - seem to have been lost in meeting up with reality. Nothing is as easy as it seems, it's no fun any more, people say; the joy and the magic have left it.
So it's left to science to pick up the credit for 'progress', and for commerce to make money now and leave the problems of tidying up the mess for someone else to solve. The more glamorous and exciting the technology, the less anyone wants to work at being dustman; the big toys of the nuclear technologies, for example, have given us problems that can, we're told, only be solved by yet more expense on bigger technological toys, that will themselves create even greater problems that can only be solved by even bigger technological toys... And so it goes on: 'toys for the boys', while the real dangers for our future are swept beneath an imaginary carpet, shuffled into invisibility behind a dazzling display of pyrotechnics and a neat 'somebody else's problem' field (to use Douglas Adams' depressingly-accurate term).
As we've seen, much the same is true in medicine. Bigger and more complex technological toys, to deal with wayward lumps of meat in a scientific manner. It works, after a fashion, but there's not much magic, and very little respect for people as people.
And none of it is efficient in a real sense; it's not exactly reliable; it's hardly elegant; and it rarely seems to be appropriate.
But we are technology: we are the magic. We cannot hide from it in some golden-age, New-Age Avalonian mists: we are here, now. It's our problem.
It's generally easier, too, to start from where we are rather than from where we are not.
We cannot start as idealists: our nature does include greed, laziness, avarice and the rest of the biblical deadly sins; so any technology, any way of working on the world, is unlikely to work if it does not allow for these aspects of reality.
We cannot start as scientists, either: that would allow us, perhaps, to start from where we are, but would only allow us to move as far as the limitations of logic will let us - and that's not very far in the messy reality of the real world.
We can only really start, perhaps, from who we are. Not defined in terms of what we do, but more described in terms of where we 'be'. In a context in which 'anything goes', and in which (through that paradox of 'things have not only to be seen to be believed, but also to be believed to be seen') we play a direct part, our approach to reality, and working on that reality, is a distinct and distinctive part of that reality. Beyond the normal 'default reality' of physics, and the not-so-normal games of the natural world, we decide what is real and what is not: for others as well as for ourselves.
The world and its effects are of our choosing. If we want to change it... ...we can change it. By looking at ourselves, through the technology that is the expression of ourselves.
We are all magicians, whether we like it or not: we play a direct part in the reality of the world that we and everything else around us will experience.
And as magicians, isn't it perhaps about time we got round to being good at it?