The following documentary contains a few very relevant aspects to below elbow amputee prosthetics and research.
It describes the journey of a blind woman that receives an experimental brain implant to restore vision, and the story of a man who lost his left hand in an accident and then got an iLimb.
This is a great documentary as it offers examples of what today is sold to disabled people as "bionic".
Story of the Robochick and Bionic Boy movie [source link]
Cheri doesn't call herself the bionic woman, she calls herself the Robochick. Cheri lives with her mother Suzi in St Louis, Missouri. Cheri has been blind since 1989 and Suzi takes care of her full-time but, she never dreamed that this would include learning to plug an artificial vision system into her daughter's head.
Growing up through high school in the 80s, Cheri was a popular girl who had no trouble fitting in. She was a dancer and did acrobatics. In the autumn of 1989, Cheri had just started college and had her whole life ahead of her. The accident happened when Cheri and her boyfriend were driving to relatives for Thanksgiving. They had a head-on collision with a truck, the impact threw her forward and she smashed her head on the gearshift. Cheri's injuries were so severe it was a miracle she made it to hospital alive.
Her neurosurgeon Dr Kenneth Smith explains "She received severe injuries to her upper face and the front part of her brain. Both eyeballs were so badly damaged that they had to be removed". Against all the odds, the surgeons were able to save her life.
As nineteen year old Cheri recovered from the accident, her doctors were worried, not only about her physical injuries but , by the psychological trauma that came with losing her sight.
The artificial vision system was the brain-child of a pioneering scientist named William Dobelle. Dobelle was a maverick operating on the fringes of the medical establishment. His extraordinary idea was to create artificial vision by simply plugging a video camera directly into the brain of a blind person. To prove that bionic vision would work, Dobelle needed to experiment on human guinea pigs. But, getting government approval for such extreme surgery would take years. So, rather than wait, Dobelle advertised for volunteers and began his own trials in Portugal.
Cheri's Aunt read about Dobelle's vision implant in the newspaper. Dobelle needed volunteers who had been born with perfect vision, but later lost it. So, Cheri was ideal and she volunteered for surgery in 2003. The operation would be painful, expensive and there was no guarantee that it would work.
Cheri flew to Portugal in October of 2004. The day before the operation she got a shock when doctors explained exactly what it would involve. Basically, it was a simple craniotomy to open the skull and expose the occipital lobe where electrodes would be placed. When the skull is replaced it would have two holes drilled to take the electrode connectors.
Despite her reservations, the operation went ahead and took more than four hours. First the back of Cheri's scalp was peeled away, then the surgeons cut a section out of her skull to expose her brain. Next, two plates, each containing hundreds of electrodes, was inserted in the folds of her brain right on the visual cortex. Two large holes were drilled through the back of Cheri's skull to allow the terminals to be implanted. Another metal plate was fitted to the top of her head to ground the electricity running through the system. Finally, her head was stitched back together.
There was a problem, one of the terminals continues to leak brain fluid and more operations were needed to fix it. The skull is trying to heal around a foreign body which it naturally rejects and Cheri's head took several months to heal. Cheri thought the scientists would hook up the cables to her head, flip a switch and boom, she would see. In fact, the scientists didn't know if the implant would work at all. They had to test each of the electrodes individually to find out which ones were live.
A camera, fitted to Cheri's glasses, acts as an artificial eye. It sends a signal to a computer around Cheri's waist. This computer translates the signal into impulses which are sent through cables to the electrodes in her brain.
Finally, during the testing, Cherie saw a flash of light "It was kind of like I was in a dark room and someone shone a flashlight in my face". After several weeks of tests, Cheri was was ready to bring the system home. Cheri is currently using only ten of a possible 484 electrodes on her visual cortex. She is able to see contrasts but, is not using her bionic vision to anything like its full potential.
The promise of a bright new technological future was about to turn sour. Bill Dobelle died suddenly in 2006 at the age of 59. Unfortunately, with him died Cheri's hopes. With the head researcher gone funding for the Dobelle Institute was withdrawn.
Cheri may never receive the system upgrade that she had been promised to extend the visual system's capabilities. To compound the problem, the system she currently has, has failed.
Jens Naumann was one of the first artificial vision patients and his system did, after many teething problems, work fully. Cheri hopes he can explain what she might expect. At one point in time, he actually drove a car.
What she doesn't know, is that in the meantime, his system has completely broken down and he is thinking of having the implants removed. He has pain, he experiences bleeding, and he suffered from epileptic seizures.
While Jens has given up on his artificial vision system, he still thinks Cheri's has enormous potential and that through her the dream of true bionic vision may, one day, be realized.
Following are a few conclusions:
- About mavericks. Some ground breaking research is done by individuals, mavericks, pioneers that do not share their ideas or even engineering principles with others. Their work may be interesting academically but everyday use can turn out to be highly problematic. Egotism, personality disorders such as narcissism, vanity, competitive feelings and dwindling or absent patients ready to serve as test series are a big problem. Looking at the questionable potential - practically speaking - distrust is in order, though.
- Don't obsess over prosthetics - other aspects of life are more relevant. For the blind, for the person with limb loss, obsessive replacement of the absent part using fringe technology is only a real solution for some. For most others, dealing with the loss, adapting to it and living without bionic or prosthetic replacement or with just a practical tool such as accessible prosthetics today is perfectly enough. After all, amputees' main everyday problems appear to be social stigma and depression, chronic overuse symptoms and the discrepancy between what is visible and what is really going on so most other people build up wrong ideas - these areas of tension are far more relevant and pressing than gadgetry that is bionically hyped. While deviating attention, these advances are not at all helping the amputee personally.
- Is it worth participating? If anything, an amputee that participates in such research helps the researchers. That may be noble and great. Whether a product results that helps other amputees is not answered with that though.
- Design principles. If individual pioneers, engineers, mechanics or developers build stuff for actual prosthetic usage, it should follow open, accessible and shared design principles. Such as like the Monestier hand, that was built so every bike mechanic could fix it.
- High tech garage servicing needed. There should be skill centers where people collect engineering skill modules to service even experimental prosthetic setups. In other words, future prosthetic technicians will have to be able to build, understand, hack, work and repair advanced electric, electronic, mechatronic and informatics setups.
- About dependency and independence. With a handicap, one tends to be a bit more dependent on all kinds of things. While getting more independent is a real nonnegotiable goal of many people with handicaps, and while getting more independent is without doubt likely to make such a handicapped person a lot happier, that is not necessarily a goal reached well with gadgetry. There, dependency risks to be shifted, if not increased. If you really want to rely on a prosthetic gadget, some requirements must be met before that is a sensible thing to do. In other words - before you start to fully attach your emotions of self worth and independence to a gadget, a set of somewhat critical requirements should be thoroughly checked and if possible met.
- So "bionic" covers two aspects in prosthetics today:
- (a) The terror, horror and hope of real technology integration into the human body, an entirely uncharted territory that has risks and an unknown future. Also, brain implant adapters can ooze for months or years, just like osseointegrated bolts. Implants can really hurt, bleed, ooze, and impede the wearer, also after years. Bionic implants are not fun to have. The effort required to run so-called advanced and extreme high tech gadgetry may be far more than will ever be returned in terms of function.
- (b) Pure hype on the other where money is siphoned off that will disappear in useless gadget marketing. Some el-cheapo fixer uppers are not "bionic" but called "bionic" - the iLimb or the Michelangelo hand are nothing but myoelectric hands. They are not bionic. Yet they are advertised as "brain controlled" but they are not - they are controlled by myoelectric impulses of stump muscles, nothing less or more.