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Amber Case - Prosthetic Culture

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Amber Case - Prosthetic Culture; published June 13, 2011, 16:25; URL: https://www.swisswuff.ch/tech/?p=436.

BibTeX: @MISC{schweitzer_wolf_1571401250, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Amber Case - Prosthetic Culture}}, month = {June},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=436}}


Prosthetic items allow or enable function. They extend our functional range. They are part of us. Amber Case gives an intriguing presentation as Cyborg Anthropologist.

Her presentation is relevant to prosthetic limb development as well.

Today, there is a blur: it is impossible to delineate - generally - where humans begin and machines end, or, where machines begin and humans end. That was obvious to me earlier, but we do feel that non-disabled people are more competent to report about such issues, don't we. For example, not allowing a school kid to have access to a mobile phone to connect with their peers can really cause social problems for that kid. It is an act of humanity to equip amputees with artificial limbs, and humanitarian organizations work towards that goal. To fit amputees with prostheses is regarded as re-humanizing them in a way. No one goes there to show them stump tricks. Once one realizes the full extent of that, one understands the significance of this blur. In fact, making tools a part of us has been with us for a while. The blur between non-human objects (as such) and people (as such, naked and stripped of devices) seems to have started early in history. Already the cave man with his hammer is augmenting his reality. That, as Amber Case puts it, makes us all cyborgs. One could indeed argue that adopting tools and objects as interfaces parts is a necessary prerequisite of being human - which then puts the pretense of Hand Op de Beeck into considerable question even more. There, the artist suggested that prosthetic limbs would "destroy the very essence of a person". Given the intrinsically human aspect of all things artificial, this is a really weird thing to say. In the context of providing humanitarian support for amputees by providing them with prosthetic limbs, it is an even weirder thing to say. Far more, one has to emphasize the "blur" aspect - only once a prosthetic arm is extremely durable and functional, light weight and comfortable will I be able to really forget about the external and object like aspects. Only then can I start to train to "be one" with it. Only then, a blur can be attempted. No one can "be one" with a heavy, uncomfortable and unreliable object. Achieving a blur is a hard requirement for an object to become a prosthetic part of a cyborg.

The term cyborg apparently was introduced to describe an organism "to which exogenous components had been added for the purpose of adapting to new environments". Becoming a cyborg is our external way of somehow escaping evolution - we skip a few million years of evolution by attaching external objects. The components used to enable cyborgs are termed techno-social and they act in a symbiotic biological relationship to "make sure" something is achieved, as she puts it. From wearing a prosthetic arm, I confirm these aspects. Prosthetic arms are both technical solutions (affording grip, counter weight, length extension) and social solutions (function required to match social expectations, and appearance required by social situations such as demonstrating visible replacement of an absent hand). A relationship only starts to be symbiotic once the external part can be adopted into a lifestyle. With around 50% of arm amputees not wearing prosthetic arms, the industry has a track record of decades of failing the user community.

The environment we want to adapt to defines what external objects we need. A classic example is space. Astronauts that go out in space are the classic example of a human cyborg that attaches external objects in order to adapt to a new environment. But even at an everyday level we critically select objects to use as attachment - whether we are part of our information society as such, whether we go hiking, whether we attend a sports or concert event, whether we go to work for any specific task as part of a particular profession - the external objects we need and require to provide for functional and adequate integration vary. This is why modular prosthetic arms are the way to go. If manufacturers do not see that pin locks, wrist units, control units, power supplies and terminal devices must be compatible for all prosthetic arms as much as possible, they have not understood what cyborg life is about. There is no way around the fact that all parts must be able to adapt, to be adapted at any level - prosthetic to human, prosthetic to environment, prosthetic component to prosthetic component.

For example, to adapt to information society in an appropriate way, we need computers, laptops or portable devices that then allow us to hook into all these information space portals - mail, Facebook, news, et cetera. They accompany us through every day. They are part of our exoskeleton that is, itself, assembled of continuous or discontinuous parts and that is defined over function. We are often considered 'low tech' cyborg as we are 'not always connected'. To adapt to any environment, an amputee can do a range of things. We can change our limb deficiency by wearing a prosthetic or by getting surgery [Krukenberg]. We can modify our environment. We can simply train our brains and bodies to cope without any further prosthetic or environmental change. Or we can ask someone else to help us and go in between our incompatibility. Thus, adapting a prosthetic is just one way of solving the problem. With this, we are not at all forced to become cyborgs in a more extended way. But as humans, living with prosthetic parts as cyborgs is close to our nature and it does indeed constitute one of the few options that we have.

Obsolete cyborg parts exist as obviously not all attempts at creating useful artifacts can be equally successful - and as a rule and out of good practice, obsolete parts must be avoided and bypassed. We shed parts, leave a trail, as part of who we are and what we do. Obviously, not all objects we use as exoskeletal parts make us happy. Dysfunctional pant zippers, wrongly mounted installations - ours is a world where everyday objects - or their manufacturers or sales representatives - can turn against us and that appears to happen quite a bit. Omit unnecessary cyborgs, as a rule and out of principle. The solution is to use friendlier replacements. The question is, what is friendly and what is not friendly. Otto Bock sold a range of unfriendly body powered parts in a possible attempt to quite possibly make their equally unfriendly myoelectric parts appear less unfriendly. That alone does not make body powered arms less friendly though. If one gets Krukenberg surgery for the stump, the result is friendly (technically) yet widely regarded as unfriendly (socially) even though that view is not really confirmed - yet, there still seems to be enough social pressure to warrant a certain degree of caution. However, the EODF, End Of Day Feeling, summing up how you feel at the end of any given day will invariably tell you if your prosthetic solution was friendly or not. You will find out.

Sometimes, science fiction precedes real solutions. Star Wars preceded the cell phone, for example. Some other parts were there for a very long time. And not all prosthetic replacements changed much over time. Interestingly, extensions of the fist - hammers, knives, spoons - did not evolve a lot at all over thousands of years. This warrants the question whether and why prosthetic arms and terminal devices actually would need to evolve at all, and if so, how.

However at one point in time - over an items cycle - its characteristics may just take off and go "information age" all of a sudden. Also, it literally hurts when your prosthetic part - cell phone, car, refrigerator, et cetera - breaks or ceases to function. Then, availability and friendliness not only of the product itself, but also of the store and maintenance personnel, starts to become a decisive factor. Examples are BMW garages or Apple stores that maintain a really nice and constructive support attitude towards their customers. Otto Bock representatives, I am confident, could benefit from considerable experience elsewhere. But at the end of the day, a product that has become unfriendly or obsolete should be shed and discarded for other solutions.

With product life being limited and with products being exchangeable, we are all shedding materials. These help create new growth. We shed cars, houses, factories, cell phones, clothes, and so on. At the same time, with new products, people may get really scared. Furthermore, some output stratification seems to occur - all kinds of activities are now summarized on video blogs or weblogs. People collectively seem to suffer from telenoia - a form of being followed by the remote, anonymous other where boundaires between a massive multiplayer game and one's own life start to blur more than one would be ready to accept or anticipate. From that blur, new creations may happen, start out digitally, then become a reality - or remain a game. Prosthetic academic research has remained a game for a very long time as it sailed under The Amputee Excuse (TAE) - conversely, living without prosthetic just using the stump or a Krukenberg stump turns out to be a far more friendly solution for a whole range of reasons - cumulative time spent at orthopedic technicians' labs (ours don't even have cell phone access), cumulative financial burden, cumulative damage to skin, cumulative damage top shoulders and elbows, cumulative time spent arguing with prosthetic component manufacturer customer service. All these are part of an equation that is a very rationally made equation.

There are always pioneers of new cyborg ideas. Such as Steve Mann. They may seem to carry really heavy equipment and not have many friends for some of their lives. There seems to be a price for that, for not being adequately integrated, but for being a pioneer there. So psychologically, being such a pioneer actually seems to be quite a burden. Not a solution. But augmented reality is under development - visual, tactile, EEG, jet packs, and so on. There is the Sixth Sense by Pattie Maes as well. If you are an amputee that is not able to carry a sixteen ton weight of additional burden as developer of a new 7 kg prosthetic arm, better to really stay away from these and learn to open marmalade glasses using your feet and remaining hand, or using a power drill as another prosthetic part of our cyborg identity that is reliable, affordable and available.

However, the reality of objects ideally blends into the fabric of everyday reality and thus fades from our perception. That is the long term goal. Maybe your brains aren't formatted correctly to plan the next prosthetic arm right now, maybe it is though.

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