"On-line gaming environments are completely different things... Essentially it's massive global role-playing."
Vashti lives in an age in which people live alone in a single room - the Machine serves all their needs. Direct experience is a thing of the past - when she faces it, she panics.
This is a very early use of the idea of using some sort of machine to allow physicians to examine patients at a distance. The earliest efforts in telemedicine date from around 1905; telecardiology via telephone was demostrated by Willem Einthoven. Telestethoscopy using the telephone was tried in the 1920's.
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