Prosthetics: Enhancing Human Capabilities


By the third of June eighteen sixty one America was war as the echoes of Kevin Hire Faded at Fort Sumter thousands of southerners joined the confederate army among them was an eighteen year old engineering student market the first mass produced affordable prosthetic lamp. I'm Walter Isaacson and you're listening in another way after serving today's world was turned upside down Kareem comes true I went from being able to somebody that might even be super abled into trail blazers and original podcast from Dell Technologies Cereal College before the civil war she says a battlefield amputees prospects were Graham the chances are they won't be able to have might say Craig Hutto is part by McMahon arms legs over three million amputees every year who need a new or replacement we don't have any money shrouded in worry James hangers family listen and wait it then on back after which hanging is freed in a prisoner exchange and return to his family home seemingly crippled for life can bend he can lift it with his muscles it means that he can hold onto a banister but he can come downstairs on although it's not digital it's or a dime shift and I think that sound of this young engineer coming downstairs and being able to walk into his parents parlor and everything changes rubber bumpers with a hinge knee and ankle for James Hanger the first recorded amputee of the civil war it was the beginning of his prosthetic would mimic a natural limb his wooden leg car from the wood used to make Balance Inc a lot of noise there's a lot of banging shuffling back and forth and I think they're generally concerned about his condition emily mayhew is a historian at London's in mm-hmm the kind of goes into his room for three months and his family sit down in the Paula of their house a May worry about him it was a genesis moment in modern prosthetics hangar was determined that unlike the straight un-imaginative peg legs of his era the day that I think of as being this real turning point they hear his door open and then they hear something extraordinary and it's James Hanger on the prosthetic leg aesthetic fitted by going to have a short relatively miserable life on crutches boesak somewhere where they can't really move they're all wheelchairs but then also available to people that day and Philip by Virginia Hangar was captured after cannonball tore through his leg a union surgeon amputated his joie something a little bit more subtle than that what really drives Madsen are unexpected survivors. Emily may you it's the unexpected survivor. A catastrophic injury to a lamb might be a death sentence union and confederate surgeons became adept at performing amputations in the field just as a civil war had transformed a nation it changed Madison and prosthetics to where in the past the global enterprise that he would oversee until his death in nineteen nineteen and which still bears his name today hanger would go on to develop on both sides of of the American civil war the surgeons get incredibly skilled they get very quick station they learn that the best thing back with a knee joint that he is an engineer has designed and he's coming down status because he's designed leg where the knee can bend and if the when the Great War began in nineteen fourteen the prosthetics industry was ready but battlefield surgeons were not prostatic fit after the patient is gone home is to leave as much flesh and muscle as possible the needs of thousands of civil war throughout the wars of the twentieth century prosthetic technology changed little yet battlefield drivers fueled a growing aesthetics industry which soon found itself serving a new category of clients prosthetics is is not only tens of thousands of them by some estimates we always talk about how much war drives medicine in fact it's not so much roads the creation of very large factories while they have in common with war is that they injure young men who are going to have long lives by the twentieth century prosthetics manufacturers including James Hangers company had expanded to Europe they would just in time people understand that perhaps people can survive wounds that they would otherwise they would have been taught that people will will die for to commute to work this is where an old pirate trope save the day one of the things that the hooked hand has a resurgence add that there was a concern particularly amongst the British medics but if they show too much material they showed too many images that it's going to put off up to hold on to a bicycle handball or indeed the ball of one of the new underground trains or one of the buses and they can still go to work as of James Hanger soon after the Vietnam era all of that changed new technologies from composites advances in robotics nineteenth century maintaining their quality of life often dependent on their ability to take on an industrial job and just as importantly biomechanical innovation and the microprocessor opened a vast possibilities for aesthetic users to the your helicopter getting them to very well-staffed Field Hospital of highly experienced surgeons and so lives would have been lost otherwise are in fact say the young doctors coming and joining up with the war effort so although the industry the processing industry is ready the medical profession is not ready not brightest minds and prosthetics it soon became evident that these advances would help overcome barriers that had lingered since the days of James Hanger Medicine made huge advances mobile army surgical hospitals in Korea or mass units revolutionized battlefield of a natural Ma'am since eighteen ninety that mission has driven many of the brightest minds of the British aesthetics firm blatch driven by by the military it's driven by the demands of industrialization so very large-scale industrial projects the laying of railways the digging of canals the lane art the digital age would see a number of Eureka moments at Blackford but not the instant solution kind you see in the movies such as how to design for static lag dig negotiate stairs steep grades or uneven ground with relative ease evacuation of casualties highly trained paramedics the team medic in the field saving a life getting them onto to a motorized ambulance that the person who lives to require more treatment to require the prosthetic limb that's the thing that really changes medicine but unquestionably mattress links system and above the knee prosthetic lamb who ankle and knee talk to each other and coordinate their actions life losing both legs it was medical dictum before the outbreak at the beginning of the nineteen sixties but if you lost both your legs your quality RV visions I think the Eureka moment comes from when you are involved in in a it was also this idea it's it's perhaps one of the most extraordinary developments in prosthetics isn't made in the prosthetic company it's made in the field hospital and providing amputees with unprecedented ease and confidence it combines four microprocessors and seven centers Addison a decade later in Vietnam care for the wounded became even more efficient you got fast Alex and pneumatics adapt to changes in the terrain today the link system is used by roughly three to four thousand your ability and strength a decade later they introduced microprocessors to static knee and eventually an ankle empties for Said's a hedy refining the technology is good but it's only worthwhile wanted widely accessible and you and we're GonNa send you home yet for all the surgical advancement prosthetic limbs themselves at advanced little since and they're going to have long lives where they want to walk all be able to ride a bicycle for the upper body amputees the old of prosthetics isn't technology but finding ways to manage pain emily mayhew we know that in the left but they're also experiencing phantom limb pain so they're experiencing pain and really distracting sensations in the limbs in the nineteen eighties the team at Blackford pioneered the use of carbon fiber prosthetics providing more flexibility across from me an ankle joints these components a constantly gathering and exchanging data allowing the leg to adjust it's ideal I really the most significant challenge for a prosthetic wearer Zaidi agrees for his team pain management falls under the first produce it when can we make available for everyone I'm what features can be ad which will move one step closer towards the totality Habilitation Zahid he and his team also understand that one of the great barriers in the field kingdom in particular fifty percent of prophetic whereas experienced pain to the point at which they are unable to work and interestingly I don't want to use really fifty years ago how is this going to be relevant and also the American civil war is is is really again the scale and the horror of the injuries are so bad stap if the joint of oppress static limb can talk to one another to govern movement how long before prosthetic limb is connected directly to the brain for one group of trailblazers it would take a chance encounter with a raccoon the to seize that or essential for successful prosthetic comfort and confidence managing the effects of discomfort or sweat in in process and in my experience the creative parts of it comes from not being scared off every solution residual limb is no less important than the mightiest micro processes and situational awareness sensors Ashley want to use the word interesting because actually tragically they're experiencing two kinds of pain they're experiencing residual pain so that's pain in what they've got left in the body that they've in my dream I think you'll rica moments happen instantly saheed Zahid he is a technical director at Blackford I take percent improvement in pain outcomes for prophetic wearers from the first World War so in one hundred years we haven't got very far on what is there was just enough time between the American civil war and the first World War for it to be a new generation of doctors for them to look back and say well this further to the applied physics lab at Johns Hopkins University in Maryland Melissa Really A it's a phenomenal story who are lower right arm or husband rushed to the emergency room where it was determined that the raccoon did not he's a phenomenal individual Mike McLaughlin is vice president of research for the tail tack and the former Chief Engineer To answer that question Canton Ohio it's early one June morning in two thousand fifteen when Melissa was to control me it was natural thing to do now why not together and complete that picture that thinking led to carry rabies but did carry a severe infection over the weeks that followed the wound worsened then became sapped that December listen loomis right arm would have to be amputated above the elbow her surgeon since is because people want to be able to hold a bicycle handful so even if they'd lost an upper limb whether they look they've lost hand for the elbow or the shoulder they want if he's GonNa be very poor and the chances are you weren't you weren't going to survive in Vietnam War the surgeon say will if you lose growth your legs we're going to save you we're going to save you loomis or the commotion and our Backyard Her dogs cornered a raccoon your instinct to protect all three animals kicked in so in Vietnam this is the point at which we see a really significant cohort in our era so not from the first or been in our era of two people who on the scale that's required so many of the lessons that those southern and northern doctors learn on the battlefields in the American civil war will be relearned on the western front its mission is to create upper body artificial limbs that were store near Natural Motor and sensory capability to upper limb amputees and those are the ones that move your muscles so you move your hand or your arm and then you have sensory nerves that allow you know your your receptors in your head if somebody has an amputation the limits gone but the nerves that used to say run down to the hand or still there and they're just not going anywhere since two thousand and six they've been working on a program initiated by Darpa the Defense Advanced Research Projects Agency behind all advanced prosthetics is the right surgery and proper Rehab Melissa's case the surgeon Dr Aj Seth not only did the prostatic arm respond to commands from this brain it went one better fee piece of muscle somewhere in her upper arm and we could detect that with those knows rematch Melissa work with McLaughlin Stein at Johns Hopkins gene feelings and sensations back to her brain and brain in conversation and so this is at the applied physics lab so the surgeon that did Melissa's operation to remove her arm what he wanted to do was to ensure actually feed it back to those those same nerves and she actually will perceive it as sensation in your fingers Akhoon by the tail moving quickly she caught the raccoon and released it over the fence but not before the animal at bit without breaking it and Mike McLaughlin it just the beginning of what's possible in neuro prosthetics breath and then when the prosthetic encounters of an object we can actually take that sensation say pressure mclachlan can cars prosthetics for for many years was very static field wasn't a lot of progress made really amazing because which essentially doing is tapping into the the old circuits so the brain remembers that the arm used to be there and it's really within the past ten to fifteen years that we've really seen connor this merging of you know advance things three D. printing has from many become part of the renaissance initiatives in the works then enable amputees engineering mechanical engineering electrical engineering computer science biology altogether to to really do some very remarkable pieces of muscle so now she thought for example if she wants to move her index finger the nerve that used to fire the muscles that would pull those tendons would now flex a little caves and bundled together is hypothermia set in and with it disorientation four days melted together I mean the tools we have now are still pretty crew it when you move your your hand you're involving you know probably a hundred billion neurons in that task no longer got we've done some research on our cohort for amputees from Iraq Afghanistan in the twenty first century and win yet we know that there's been about a one the hospital with her was diagnosed with severe frostbite soon after both his legs were amputated below the knees able personal insights he vividly recalls the labeling that came with becoming an amputee after that the next innovation felt self evident I think having been Sokoto line call and we map the nerves in your arm to interact with the prosthetic what he did was a technique known as targeted re innovations and so what targeted re innovation does is actually give those nerves a place to go and see how basically two types of nerves you have the motor a still remembers where those nerves went so it becomes a very easy way for someone like Melissa to control the prosthetic because she can think about moving the prosthetic and it'll move on this line of thought was unacceptable and I quickly realized that that was complete nonsense I wasn't broken the technology that was it's where to him. The renaissance is just beginning not only disproportional her embodied the media labs will work he provides in value today professor her leads a prosthetics innovation team at the MIT media lab in Cambridge Massachusetts purrs creative outlook early in his recovery he realized that the artificial part of himself was malleable and could assume offered to me was absolutely ridiculous it was without computation without sensing without actuation they were dumb limbs lacking any any number of shapes and functions he developed a specially crafted pair of percents legs slightly longer and lighter than natural ones that actually made him a better climber the prosthetic developed at the media lab today is to scan and print their own customized aesthetics dramatically reducing the time and cost of manufacturing affordable I couldn't really put the hand in the sort of line of time and say that was a time to me it was more the question of when can be masked without looking at a percentage hand Melissa could grasp Styrofoam Cup without crushing it and pick up an egg proteins it's Oregon's tissues to really have a more clean cohesive communication between the nervous is the time when designers design they view the human body as in variant and unchangeable and they designed components to fit that unchain or that she was able to use you know in advance prospects and he'd been kind of watching what people had been had been doing in the field and was was aware of it allowing him to walk run jump and even dance with the confidence that generations amputees could not have imagined the weather change faced with hundred mile an hour winds and a wind chill of minus one hundred and ten degrees Fahrenheit the two men Doug Snr Hers Team Imagines Advanced Prosthetics Moving sports beyond the sort of running blades that Oscar pistorius system and synthetic computation as a walking illustration of his team's work professor hers legs are we're seeing you know just a handful of those right now blatch words heeds he believes where the renaissance of prosthesis elegantly robotic looking a number of computers and dozen centers work with a series of muscle like actuators behind all these remarkable initiatives or equally remarkable people one fan morning Janet I was told by doctors and nurses all of society that the technology was wonderful it was what we had it was always going to be what we had the feel like one single twenty four hour period death felt they were discovered by snow shore and airlifted was an animal lover and volunteer at the start counting dog pound she ran out to see that one of the dogs at the because most humans can walk but we can't describe how it works and they're they go up and down steps and slopes and their their legs are doing these extraordinarily complex movements and they're they're magnificent human machine I'm Walter is changing body we're relaxing that in your own body design and were think thinking about how can we

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