By Dean Kamen
The United States military has become very successful at treating our service men and women who have been injured in the field. Wounded soldiers—whether they’re in the middle of Iraq or the distant hills of Afghanistan—are quickly and effectively given the best medical treatment available, better even than the emergency care that most people might get in the average American city. Where our military has not been as effective, however, is how best to aid our soldiers as they recover. This is especially true in the field of upper-limb prosthetic devices.
Consider this—a soldier in the Civil War takes a musket ball to the shoulder and has to have his arm amputated. In the 19th century, the prescribed prosthetic device for that soldier was a wooden stick with a hook on the end of it. One hundred and fifty years later, even with the extraordinary leaps in technology that have come with the 21st century—from nuclear-powered aircraft carriers to the B-2 stealth bomber—a soldier who loses an arm fighting the war on terror will be given a plastic stick with a similar hook on the end of it. Of all of the incredible advances we have made in treating our wounded warriors, prosthetic arms have barely developed beyond what was used more than a century ago.
I run an engineering outfit in Manchester, New Hampshire, called DEKA Research & Development Corporation. We have nearly 400 engineers, most of whom are focused on cutting-edge research and development for medical devices and other applications. At DEKA, we pride ourselves on approaching technological problems with a fresh approach and a game-changing mentality. We embrace the challenge of innovation because it leads to new ideas and new possibilities. Despite our past successes and achievements, however, we could not have been prepared for the challenge we received from the Department of Defense—develop a new prosthetic arm and make it better, faster, and stronger than any that had been previously available to anyone.
In 2006, a collection of officers and doctors from DARPA—the Defense Advanced Research Projects Agency—paid us a visit in New Hampshire. DARPA is a fascinating organization with an impressive history. Founded in response to the launch of Sputnik during the Cold War, DARPA has committed itself to providing the U.S. military with the very best and most sophisticated technology and capabilities. From advances in warplanes and ships to the early iterations of the Internet, DARPA has produced technology that has transformed not only our military, but our nation as well.
The DARPA representatives came to us with an ambitious plan to revolutionize prosthetic devices. They challenged my engineers and me to create a robotic arm that was capable of functionality and degrees of freedom far beyond that standard stick-and-hook. The arm had to be the same size and weight as a 50th percentile female arm, while being totally self-contained and powered. It had to be able to pick a raisin off a table without dropping it—requiring fine motor control—and it had to be able to pick up a grape without crushing it—essentially, complete haptic response. The arm had to meet all these criteria—and it had to be ready for trials in two years.
I’ve never been accused of mincing words, so I gave the DARPA officials my informed opinion. I told them they were nuts.
It just didn’t seem possible to create a device as advanced and streamlined as they wanted in that short timeframe. I was prepared to decline the project when a particularly passionate surgeon in the DARPA group gave me a piece of information that stuck with me. He told me that more than a dozen soldiers have returned from Iraq and Afghanistan with not only single, but bilateral amputations. I thought to myself how much my life would change if I lost even one arm. But compared to losing two, the absence of one arm would seem like an inconvenience. I tossed and turned in bed that night thinking about these soldiers, and then realized that they wouldn’t even be able to toss and turn.
The next day, we accepted DARPA’s challenge.
Before we could begin the actual design and construction of a prototype, we decided to spend some time traveling to various places like Washington’s Walter Reed Army Medical Center in order to talk to amputees and gain a better understanding of the sorts of hurdles they face and the elements they would want to see in our new prosthesis. Having the opportunity to meet face-to-face with these brave men and women has been perhaps the most rewarding aspect of this entire project. Their resilience and courage is beyond measure. One story in particular stands out.
We assembled a group of military patients who had experience using prosthetic devices. We explained the technological compromises and trade-offs that needed to be made to create our Arm. Fine motor control or curling strength? Rapid movement or power? The soldiers’ ideas and enthusiasm astounded me. After all they had already given, they still wanted to do more.
After a while, I noticed one of the young men had been conspicuously quiet. He sat down at the far end of the table, his head resting on his one remaining arm. I called over to him, asking what he thought. The young man stirred and said, “You know, I’m one of the lucky ones. I lost my right arm—but I’m a lefty.”
I almost couldn’t believe the strength of this man’s spirit. And then, as we were leaving, I saw the same man push away from the table—only to reveal that this “lucky” soldier had lost one of his legs as well.
Before we visited the hospital, I had warned my engineers that the patients we would meet would almost certainly be angry and frustrated, with insufficient tools and understandably depressed attitudes. We expected that in order to gain their cooperation, we would need to provide support and encouragement. As my engineers and I left the hospital, however, it was clear that we had not needed to provide them with inspiration. Instead, their bravery and optimism had inspired us. We returned to Manchester and worked faster and harder, motivated by the heroes we had the honor of working with.
After one year, we had our Arm—14 degrees of freedom, correct size, completely self-contained. I assumed that it would take several more years for us to make this new device functional for a user. But I was once again reminded just how remarkable the human capacity to adapt is. With less than 10 hours of use, we had two patients playing with a rubber ball, picking up cups and drinking. And, as promised, picking a grape up off a table and eating it.
One of our users, Chuck, had lost both arms in an accident nearly 20 years earlier. He quickly became adept at using our Arm, and was able to do something I cannot—scoop up cereal with a spoon and eat it without spilling a single drop of milk. As he did this, his wife stood behind him with tears in her eyes. Chuck hasn’t fed himself in 19 years, she said, so you have a choice—either we keep the Arm or you keep Chuck!
The story of our Arm—nicknamed the Luke Arm after the prosthesis Luke Skywalker wears in the Star Wars films—isn’t one of sensors and motors and gears. It’s a testimony to the resilience of the human spirit and our ability to respond to trauma with extraordinary courage and capability. The astounding attitudes exhibited by the soldiers and patients that we’ve come in contact with have given us the inspiration to drive forward with this project.
I hope others continue to develop new and improved devices to help our wounded warriors on the path to recovery. As long as the military continues to refine and develop its weapons technology, they should also continue to invest in new methods and devices that will give our soldiers and veterans the capabilities and support they so clearly deserve. Further development will not be easy. Technological innovation never is. But if, like me, you’ve had the chance to meet these men and women who have given so much and asked for so little, then it is clearly a challenge that we must accept.
–Dean Kamen is an inventor, entrepreneur, and a tireless advocate for science and technology. As an inventor, he holds more than 440 U.S. and foreign patents, many of them for innovative medical devices that have expanded the frontiers of health care worldwide.
Stories in this Series
Dec 4, 2011
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