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Prosthetic Envy (discussion panel roundup)

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Prosthetic Envy (discussion panel roundup); published June 1, 2016, 12:47; URL: https://www.swisswuff.ch/tech/?p=6090.

BibTeX: @MISC{schweitzer_wolf_1571448458, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Prosthetic Envy (discussion panel roundup)}}, month = {June},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=6090}}


On Tuesday May 31st, a discussion with the subject "prosthetic envy" took place organized by "Virtual Futures" in London (UK), allowing protagonists of our time to express their views.

Summary / abstract of the event:

Prosthetic envy describes the condition under which someone might claim to be willing to remove a perfectly healthy limb in order to replace it with a bionic or machinic equivalent.

As artificial limbs and assistive devices become increasingly sophisticated they have evolved from symbols of loss into desirable design objects. Recent developments in materials science, processor speeds and myoelectrics mean that new prosthetic devices exemplify the latest in technological development. This technological potency is rapidly creating a new relationship between the users of prosthetics and their 'unenhanced' beholders.

Amputees are already opting to remove healthy tissue to make room for more powerful bionics or to allow for a more intimate integration with their prosthetics. This contrasts with the traditional narrative in which orthopedic surgeons have considered amputation the equivalent of failure - the aim of medical professionals is to save as much of a damaged, injured, or diseased limb as possible.

Additionally, some amputees are opting to have their current artificial limbs upgraded with additional functions (such as a mobile phone charger) or with aesthetic enhancements (such as ornate 3D-printed covers or LED lights). Such embellishments reframe these devices as fashion statements and further drive the possibilities of and desire for self-enhancement.

But these prosthetic promises must be approached with scepticism. Prosthetic limb users note that current devices are still inconvenient. The current interfaces between the device and human body can often cause pain and abrasions on the skin and the prosthetic is prone to break. As such, it is important to acknowledge the limits of these devices before pointing to prosthetics as an early example of the sorts of tools that might enable an enhanced future human.

What does it really mean to have machinery incorporated into the body schema? How does upgrade culture operate on the body? Where does the techno-fetishism for prosthetics originate? What might drive an individual to have their limbs removed or replaced with bionic equivalents?

What does it really mean to have machinery incorporated into the body schema?

In essence, the "adoption into the body scheme" follows the universal "adopt me" paradigm that I first observed decades ago. Then, Boris Becker played Wimbledon. He scored and the German commentator screamed with joy, "*we* made a point", "*we* are winning here", and when he lost a point, "*he* lost a point", "*Boris* did not play this one so well" or "*he* was unlucky". So I realized that generally and without further reflection, we tend to only adopt what is good or works as ours - once a thing or person, a subject or object is bad, faulty, evil, ugly, non-functional or non-compliant, or otherwise rejected, rejectable, it is "theirs", "someone else's", an "outcast". This definitely extends to prosthetic arms as well: despite any intrinsic value, we are only able to see the extrinsic value.

When it works, it is great, its instrumental value is positive, and then it can be mine. Only then. If things dos not yet work that can be forced to work - so if there is limited or no extrinsic value but at least extrinsic potential - then it can, one day, possibly, be mine, depending how far I (or others) are able to push that technology. But one way or another, the primary goal is to have the prosthetic thing work always; the reason I really need my prosthetic to function and be robust is so I can adopt it as body part! When the prosthesis helps doing stuff (and when it is not in the way) it is great. Only then. So it must be maximally useful, in a purely functional dimension, so I can adopt it as mine. As experience shows then (and only then) the adoption "as mine" works flawlessly. Its clueless noisy weak grip aspects, on the other hand, made my first days with the i-Limb entirely weird. I felt like a strange machine was hanging off my stump that was as alien as could be - and despite the "hand like" appearance, it felt more remote than an army artillery exercise in any way conceivable. Not like the immediate, direct, scaled and tightly controlled hook.

Given the job that I have and the things I do otherwise, from all prosthetic components that I tried and tested, used and worked with, the best working arm resulted to be a massively tweaked body powered arm (that does away with all the glitches known from others or from literature, so really the body powered arm I wear is a different beast from everyone else's - and so ultimately, you quite possibly don't even know what I am talking about); and over the years I found that I usually do not very often swap a regular aluminum hook once it is on there for another terminal device. Whenever I do need a hand-hand, it will be a Becker hand.

This is the result of trying just about all there is. I use other devices, I have Becker hands for anthropomorphic approximation, I have a cosmetic/passive arm for when looks really matterĀ  - but really, I wear that body powered prosthetic arm or no prosthesis. My myoelectric arm neither holds up functionally or statically, nor does it work particularly well given the actual tasks; at this moment, trying to make that thing be functional is still work in progress, it is still subject to possible improvements. But it is not "mine" yet.

When the prosthetic arm falls apart, when it causes me to run for repairs, when it causes me extra costs or trouble, then we have a problem. When it does not work, it is a problem. Then it is not mine any more. Then, the lack of cooperation of the manufacturer that also produced ill designed materials, that hires far too many manager type employees that lack technical as well as communicative understanding, have no technical experts to ask and to rely on and absolutely no understanding of the amputee, combined with the lack of cooperation of the insurance, that does not really want to pay for the same cheap shit over and over again, can easily cause a situation where pure rage is the first emotion and a clear resolution to technically beat one's way out of that lock down the second one. Then I am even more (not less) without that type of prosthesis. Then, the situation, overall, does not just cause indifference - it can fuel raw hate. If it wants to be mine it better work hard, work always and function really well. If it does not, these situations better be played with ease and dignity. If one customer service agent acts as if amputees are stupid, they are done. To sell crap, to charge dream prices, and *then* act arrogant, given *that* situation - is begging for a flogging.

As the body powered arm that I wear is a very tightly controlled extremely robust thing, as an analogue device that seamlessly integrates with body motion, it feels just like an ultra tight race bike feels as a ride - after a while, it blends with the body, just as a really well built light and sturdy bike feels (I fear you have to be a bike rider to understand). It then becomes one with the motion or intention. There is nothing quite like it. For that, however, the "ultra tight race bike" paradigm must be realized and put into the design and build of the arm.

How does upgrade culture operate on the body?

The only "upgrade" I see for my body powered arm is better parts manufacturing, better implementation - the paradigm, the strategy for controls, the modular assembly, all that is already optimized and set. There are no actual upgrades to that any more.

Otherwise it works just as a new pair of skis or a new bike. Great until it breaks.

Where does the techno-fetishism for prosthetics originate?

I have no techno-fetishim for prosthetics. But I am definitely after the above mentioned aspects.

What might drive an individual to have their limbs removed or replaced with bionic equivalents?

Usually, desperation.

It is relevant to put "bionic" in quote marks when talking about "bionic" hands. Therein lies a world of difference when trying to express "understanding". Only a flawlessly robust and reliable part is mentally adopted into body space. So far, development and build of these devices has not implemented that so really, people with "bionic" hands are just that: people with "bionic" hands.

So one can only speculate what is going on when individuals feel driven to have a limb removed "in order to" have it "replaced" with a "bionic" "equivalent".

Really, there is so much wrong with the wording of this question.

Some statements on video

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