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"Robotics"/"Cyborg"-ism and prosthetic arms - state of the art, and choice of role of prosthesis within own body image [analysis post]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - "Robotics"/"Cyborg"-ism and prosthetic arms - state of the art, and choice of role of prosthesis within own body image [analysis post]; published January 29, 2017, 17:23; URL: https://www.swisswuff.ch/tech/?p=7065.

BibTeX: @MISC{schweitzer_wolf_1571389846, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - "Robotics"/"Cyborg"-ism and prosthetic arms - state of the art, and choice of role of prosthesis within own body image [analysis post]}}, month = {January},year = {2017}, url = {https://www.swisswuff.ch/tech/?p=7065}}


Currently, "robotics" if not "bionics" and prosthetic arms are seen as a somewhat "hot topic". Even though some proponents sometimes appear to get lost in the apparent breadth of the field [link].

I am not following that research path myself too systematically (bwahaha), but I am interested in relevant aspects that fall off the truck, that are byproducts of that discussion, that may help me understand me or others better.

With "not  too systematically", I mean that I have tried and that I will try to walk new paths that have not been walked before: me introducing the Red Hand in 2009 was a first; introducing 2d cut pattern approaches to tackle 3d shape problems was not available anywhere else; wearing a semi-transparent white PVC glove to define the Becker Phantom hand, and getting Centri to make me red PVC gloves for my Becker hand was definitely another first; and me awkwardly mis-understanding the Cybathlon as an actually technical competition and as that being the only one to actually provide a technical write-up (an amputee "discussing" technical research, uiuiui!) definitely was a first (in fact we have not seen anyone else actually sitting their butt down and really telling us what, technically, we get to see there for that prosthetic arms race, which is like having a soccer match but no one understanding leave alone explaining how kicks, balls and possibly passes actually work). And, providing user driven developments for real work applications was also presented by me, in person, at that Cybathlon 2016 Symposium. Not that there were many like-minded individuals, no no.

So let us cut to the chase.

The media and prosthetic manufacturers currently totally bet on one horse: the "bionic" horse. Conceptually, it is dead (sure is), but as we all know, we all do master the art of riding dead horses.

With that, we see users of (normal) myoelectric technology paraded around as representative of some new type of "cyborgs" with body powered arm users such as me chiming in, totally - the reason being, as we must assume, for lack of better alternatives. So right now we all pass as Cyborgs but mind you: enjoy that while it lasts as that cannot last forever. A small number of us can afford that honesty, so, to you all, cheers! : ) High ("clunk")! (that what happens when two pseudo Cyborgs try a high five with that artificial part there). Now, we all did not want to be Cyborgs in the first place, but we ended there, getting that label somehow. In this society, however, we would really love to see actual Cyborgs, that means, people with total tech implants, that reflect on them being real "hard core" (bwahaha) Cyborgs, but so far, there just are not that many around. To be a truly interesting Cyborg, one that warrants these long discussions, it helps to have significant amounts of, or relevant, body parts that are technically enhanced and replaced, so having a few vital organs replaced or a number of brain implants, or some bolted in deep bone works or so, really is a big factor in shaping that role.

And so in short: we are not there yet. Definitely not as hard-working arm amputees. So for now, we put up with simple "slip in" / "slap on" users of myoelectric arms and with that, any "slap on" tech including good old body powered arms with hooks, grippers or other devices will do just as fine. Of course, we could even ask: what social mechanisms keep us from reaching the truly excessively rebuilt human cka (correctly known as) "Cyborg".

So we put up with what we have, and there, arm amputees currently rock. We could ask drivers of cars or wearers of glasses with comparable cultural or epistemological justification in "being Cyborg" to sit down to talk about their own view on themselves "being Cyborgs" - ... were they not just too bourgeois, and, lacking class, and, overall, far too boring. So the answer to that injunction is: I wear glasses, I drive a car, I have a hosed arm, ... but: no one stares at my glasses or my car.

Get it?

And we all already know some of the outgrowths of established "Cyborg" type technologies such as driving (road rage, rage against anonymous, falling asleep while driving, texting while driving, driving cars that are not roadworthy, car sharing, taxi drivers, global warming, etc.) to a degree that we are almost sick of it. So, that type of "Cyborg"? Naw.

But prosthetic arms? How to cook, prepare vegetables, make salad? Great stuff. At least for now.

Yeah, prosthetic arms, bitch!

So really, the discussion about Cyborgs with prosthetic arm users, that one is about sociological entertainment, as a quick glance under the epistemological hood already shows that no other reasons are left. It also gives a range of philosophically or ethically tagged individuals the opportunity to try out their thinking process in context of the subject matter while ultimately, their general undertone ends up to be more that of sheer fright than hopeful excitement [1].

What if I delivered your newspaper, or came to get your garbage, wearing a prosthetic hand that performs better than your human hand?

(....)

You would not even have noticed, I know. You are glad the garbage is gone though, and your newspaper is delivered.

(...)

Aren't you.

(...)

So, what is going on with you?

(...)

This was never about me, ever, hm?

(...)

So, yeah, I got it.

This was never about me, or any arm amputee, personally.

Much rather, this exposes society as embodying a conglomerate of goals, wishes, roles and capabilities that are, at least in part, directly conflicting: it represents a very clear double bind when society wants to integrate and empower arm amputees, at the very same time as one designates and ostracizes them with a clear and very visible, audible and perceptible disability and disfigurement label, even portrays them as mentally unable to choose the right prosthetic arm solution for themselves and then writes pages on pages about how fearful a prospect of amputees with fantastically dreamed up "enhanced" functions is. Hell, even our University here teaches that "the disabled" (all, comprehensively, including physically and mentally disabled as one) are typical examples for "permanently cognitively impaired" people. At the same time, academic research here produces anything but viable prosthetic arm solutions for real work, while proponents keep telling everyone just how near and frightening the prospect of "Cyborgs taking over society" is. That is like the neighbour's five year old walking around, drumming on an old pot, yelling "cars for sale" - mostly irritating, maybe somewhat endearing, but definitely no actual correlate far and wide, not even a mental concept of it.

Society currently even may go mad over this double bind - all the while almost no one actually sits down and builds better prosthetic solutions today that we can use tomorrow, like, order and test the day after. Double binds are useful as they allow us to see the madness within, as well covered as it otherwise may seem: no rationally reflected person (or society) will hold on to double binds for too long. And if someone is that confused that they want opposing things at once all the time, usually their guardian, critique, their angel voice will constantly try to get them to be mum about that, lest everyone sees what is going on. You do not want to overadvertise that really, it is you that has problems understanding. You want to keep a lid on that. Conversely, as arm amputee, trying to make a society that suffocates from their own double binds "happy" is, bluntly put, a total waste of time. More politely put, we cannot put back into society what God left out, and if empathy and technical understanding is lacking, then, be it.

At the same time, the subject of developing prosthetic solutions do not seem to be highly esteemed in engineering circles. There, space exploration or rocket science, nano technology and automotive as well as real robots are what go places. Prosthetic hands typically were just used as show case, for a robotic department, to siphon off a bit of health care research money and pump it towards military and space exploration applications - but even there, industrial grippers deliver better performances than the ever-same "anthropomorphic" human hand shaped grippers. Even for "normal" work, it helps to build a heavy large device such as the DLR hand. Not the small tiny uselessy miniaturized versions that we still find too heavy (or, then, too weak) to use and wear.

Of course, real life in the field is hard: building devices for hard use means (impossible for most non-disabled people) to face wreckage and failure, to enter revise-rebuild-retest cycles and (worse) to enter a true on-eye-level dialog with amputees. But academics become academics for social status also, and even just theoretically facing an academically developed prosthetic arm (just imagine!) getting wrecked again and again is clearly far more humiliating to them than when I, myself, build some arbitrary prototype #5, wreck it, and take the results back to the bench myself before prototype #6 is made and equally wrecked. Then, the real prosthetic hand developers are gods unto themselves ("why won't God heal amputees") and they perform equally poorly (if at all) when facing simple, easy to understand and justified criticism of their products. We know riding dead horses, and we know accentuated personalities, and, we also realized they may even compliment each other.

Just having heard a very interesting talk by Thomas Metzinger about our phantom selves, I feel as if our current society is standing, glued screwed bolted to the ground, right here, and as if this our current society stares at its future self, that is standing in front of it, all avatar and all virtual and shit, but glowing with hope and absent reality, with the transparent one in front getting all the love, and getting all kissed, stroked and cuddled, also because of the cool Cyborgs that this future society was always meant to produce (but the current one has no clue how to go about). Like car companies prematurely throwing their "2018 concept study car" onto the market already in 2016, untested but gloriously looking, with the 2018 label. They fell in love with their own simulacra and forgot there was no world to correlate with that particular map [see: Baudrillard]: "Baudrillard continues where perhaps he should have started - stating that 'utility itself - is a fetishized social relation just like the abstract equivalence of commodities' (Fora Critique, p. 131; 155). It is what constitutes use value that counts (the idea of a true utility), and which has been neglected,through the '[abstraction] of the system of needs cloaked in thefalse evidence of a concrete destination and purpose, an intrinsic finality of goods and products' (ibid.)" [Hegarty, Paul. Jean Baudrillard: live theory. A&C Black, 2004.].

And without hesitating a bit, current society steps towards this future society, towards a conceptual shell lacking any substance, in a void assumption that that step will actually take it there where the strokes, cuddles and hugs can be had. It is a first step forward into true emptiness. With that, current society has a permanent Deus Ex hallucination that it staffs with embodied lookalikes, and it is hungry for cuddles and strokes, hungry for praise and love, for "delivering" Potemkin type hand simulacra instead of actual "bionic" hands in an attempt to live a movie dream of the seventies - the "Luke" arm. And while heavy weighted and strenuous, expensive and culturally interesting efforts are being made, they never reach any significance in terms of a type of escape velocity to leave the vicious cycle of prosthetic arms. That is why all current academic research in prosthetic arms will belong, subject wise, to the philosophic faculty subjects and not to any technical or health related university subjects: it was never about helping amputees, but about the investigative journey and what that may teach us about ourselves.

All the while, actual Cyborg aspects remain, technically, deeply buried underneath the "cargo cult" that currently dominates the prosthetic arm scene with its permanent "bionic" irritation. Just because you can 3D print it [see, e.g., Open Bionics arms; Enabler disclaimer statement] that does not mean you will win the next tennis match with it. You would have to understand 3D-printing first, too - as rapid prototyping is not intrinsically bad. There are other traps here: just because they make electrodes into the prosthesis that does not mean the sweat induced metal skin reactions causing difficult to heal eczema necessarily improve anything, leave alone electric conduction or myoelectric control. Just because this iLimb manufacturer insists their products are superb does not mean their gloves live any longer [car wash, glove left alone, solution: 3D printed adapter / bebionic glove]. Just because it looks funny does not mean it actually is "bionic". Just because it costs a lot does not mean it is worth anything. Just because they sold some tickets and have a technical university send people there does not mean they understood the technical problems at stake. Just because they can shift the dependency of an amputee, from daily skin care (stump skin, prosthetic sockets) to permanent long term wound care and permanent lifestyle restriction (osseointegration), does not mean that their degrees of freedom increased any.

Pure "cargo cult" for time being, as Cyborg hopeful, if you want - but no actual planes to actually fly.

And with that, society tries this massive step towards its future (but currently "phantom") society as if Cyborgs were any more real by having Potemkin arms, "cargo cult" parties and enactment "competition" lookalikes simulating a future that we all wanted to have, here, 20 years ago. So really, the dead horse of "bionic arms" that everyone tried to ride for so long slowly starts to stink, and quite understandably, that visual image per se does not make people happy. So, the puppetry acts get crazier. Freedom for amputees, i.e., less dependency and less broken or damaged prostheses, less stump skin problems, is not improving anywhere, as that is what I suggest will mark the begin of a true Cyborg era. Not the shift from a dungeon 1 where the body powered arm breaks every 4-10 days because it is built for obsolescence, to dungeon 2, where you may get an osseointegration setup mounted into your stump that permanently oozes Staphylococcus aureus, that imparts serious cold temperature induced phantom pains, that has you sit around without an actual prosthesis as no one happens to build that just yet, that has you permanently clean wipe and disinfect everything because now you have a permanently open wound, that means you are not going to all neighborhood outdoor pools as you did before, and that you have to pay privately for some 150 000 to 300 000 USD all in all (because, hey, "freedom" ?).

A true Cyborg future will not shift or increase massive dependencies with massive restrictions by exploiting amputees for top dollar. It will necessarily provide a type of setup that allows for an uprising. After all, academics are busy spreading fear already [link]. You cannot have uprising with a battery that fails every 2 hours and gloves that die within 10 minutes of some silly car wash. That would come across as silly.

The more they try, though, the less they realize that my body powered arm, now with three serious innovations on it, ploughs away 24/7, no batteries, at all temperatures, full speed, with a heavy duty impact and investment to true output turnaround anyone can only dream of. A societal or general realization that paradigm reversal (see below) already has happened, in every day life for arm amputees, is far away. A clear question of intellect, certainly not the philosophical type (even if they do not know it yet, but that is the coal mine where prosthetic arms researchers are located, too) and definitely not the technical type (if it was, we sure could identify it at the Swiss Federal Institute of Technology?), but the street wise type, I would say.

The real issues are, of course, that the social mechanisms that made any true progress along these lines possible or impossible in the past decades, are exactly the same ones today. The same academic project rating mechanisms (who gets to sit on national funding review boards), the same insurance reimbursement mechanisms (the more costly a prosthetic arm part is, the more money also for the sales people given fixed percentages), the same social mechanisms that amputees are faced with (we get to shut up, or talked down upon, for the most part) - nothing is different.

Unless these are seriously overturned, nothing can and thus will change. Society currently has a love affair with its projected phantoms - but it is too dumb to see that this love is in vain.

That is why as a society, we will keep having further useless university projects, and, totally separated from that, ultra pragmatic super lean development and production by the amputees themselves that are, with good reason, "sick of it", as they have always been.

But you cannot build useful arms, or work, or be upset about social aspects of prosthetic arm development, all the time.

Time to play

There is time to play, and being a Cyborg or Cyborg-lookalike (not that any of us really could tell the difference, right?) has a lot going for it these days (right?), or so it appears (you agreed, didn't you?).

And us arm amputees that manage to "use" a "bionic hand" seem to be able to raise great philosophical, sociological and in fact existential subjects, so in other words we make a great conversation piece, can attract all kinds of attention - hell, not grip wise, no! I hope you are over that (right?). Really, on the axis of the potentially normative, the anthropologically nonsensical, along all symbolic (not tangibly real!) dimensions, we may - and on any occasion do - serve as relevant study and conversation objects.

We are the new embodiment of what formerly was known as Freak Show. You have to realize that no "bionic" hand is made to be really silent, and none is made to resemble a real human hand too much - because they want us to stand out, they want us to sound like a machine. I had actually asked several representatives of "bionic" hand companies explicitly what they thought about switching down the motor revolutions to silent operation, and they actually said, that the sound "was a feature". Go figure! We are their new Cyborg puppets! We are meant to squeak! In their imagination, we are meant to embody where they (not necessarily we) want to go!

They play us as puppets, bottom line. Participating may be anything, but authentic.

So we also appear to figure low on the dominance scale at least inasmuch as our expected behavior and role goes (which does, on occasion, cause conflicts when some of our real behavior may be quite different). We can see that illustrated in a very strange photo exhibition that was actually co-sponsored by Otto Bock [link].

As that, we certainly represent a less pre-defined group of norms, expectations or goals - or so it appears, and all that makes us sufficiently less uninteresting than car drivers when "discussing" their role, say, as "cyborgs" or as "integrating technology into their bodies". In other words, we arm amputees that wear "bionic" arms serve as the ultimate fresh break entertainment in the newly drawn up "Cyborg" arena just to prepare the stage, until some more real, hard core, true to bone "Cyborgs" waltz in.

And as long as there are no useful developments towards actual hard core Cyborg implements but only risky, rogue, maverick type researcher driven attempts to masquerade us into modern day Frankenstein puppets, you can safely assume that the current Cyborg/Cyborg-lookalike dimorphism will remain obscure, so to say, and that the stage is all ours.

Also, as arm amputees, we may indeed be a bit disfigured - were that not the case, no one would throw added dead weight in the form of hand shape approximated robotics after the whole subject, but just pure gripper technology -, but often times we are disfigured only on our arm, but not so much in our face, so while we talk, any TV camera (or whatnot) can always go back and forth between our (usually very attractive) face and our (usually) stereotypically  disabled arm. And that - back, forth, etc. - makes for great Freak Show circus theatralics - show prosthetic device or hosed arm (cringe) - show beautiful face (relax, feel good) - show prosthetic device or hosed arm again (cringe again), and rewind play until they grow sick of it.

Nothing sustainably tangible that comes out of it though, but that never was part of a circus anyway.

And, well yes, tell me, am I being cynical here? What is it that you truly desire?

Our own body scheme

Given all that, do we accept "robotic hands" into our own body schemes and what if we do (or do not)? It seems to be an interesting assumption that the necessity of wearing a prosthetic hand, finger or arm is worded as being a "medical" necessity [1].

However, it seems to be rare that a doctor insists and prescribes a prosthetic arm.

Really, the users (much more than the "patient") themselves reflect on usage characteristics of various aspects across different available technologies (just as I do in this post, and more extensively, on this website) and come to certain conclusions as to what they want. The users push the wish, need, requirement not from a medical but from a manual or social angle.

The justification to wear a prosthetic upper extremity device usually is a long term medical one with respect to orthopedic dysbalance, asymmetry or overuse (so the example of a "medical necessity to wear a Cyborg-type USB finger tip" is strange [1]), as much as it is a short to mid term one related to job, activity, tasks, profession and social environment.

But no Cyborg philosophy text reflects that my body powered arm is worn for asymmetry reasons to keep my neck and back balanced. Indirectly, yes, we are regarded also like cattle that costs an annual keep and there, interestingly, we read that "The U.S. National Center for Health Statistics reported in 2003 that the average senior citizen with no activity limitations cost about $4,600 in health care, while the moderately disabled senior cost about $8,500 per year, and nursing home residents cost about $45,000 per year." [2].

Even, or particularly, then, when true utilitarian aspects are checked, body scheme integration of a crappy, faulty, useless but realistic modern and hyped up "bionic" prosthetic hand may significantly add to cost and suffering rather than truly, efficiently, politely and quietly reducing it. Zoning in on the aspects of rubber hand illusion and body scheme, it becomes apparent that only a well greased and functioning prosthesis is sensibly "adopted" from a user perspective and from my view, that is all it takes. One may become a "super user" automatically once the technical aspects are solved. The thing is that other than me and maybe a few others, the average amputee will be equipped with a crappy prosthesis. So really, the "law of the stronger" rules: only the amputee that has the better capacities, options, networks, resources, support systems, can effectively move himself through the troubled zone that is the first steps. And that is contrary to most public support system ideology. That aside, reality is that of dysfunctional myoelectric arms while body powered hooks are spat upon with an impressive effort. Now on top, psychologists are now coining tricks to introducing neurological trickery to get amputees wearing myoelectric arms to adopt these crappy arms into their own body scheme. And that is a recipe for true disaster: you fall in love with something that falls apart quicker than you ever believe possible. Disappointment in the worst sense is pre-programmed. And, as we know from social media, that is exactly what happens already. "Told you so".

 

Integrating a particular prosthetic arm into one's body scheme altogether and thus becoming a typical "quasi Cyborg"

The current paradigm is that as a true blue 2017 "quasi Cyborg", I adopt one of the "bionic" hands that are available right now (which usually boils down to a prosthetic Touch Bionics iLimb hand or to a RSL Steeper BeBionic hand).

And that's it.

We pick one particular model, and we stick with it.

We may even get hired by the companies as some type of "ambassador" or "key user" and as that, we get to sit in all kinds of TV shows or seminars, where we then freely answer all questions pertaining to our newly acquired "Cyborgism". Now, not me, personally, but some of us, the ones that have time for that, look good and manage to sell that newly acquired technology as "body part".

But we pick one model, identify with it and then "we are that hand" or so the assumption goes.

Now, to be able to successfully master a TV show, or seminar, one needs to at least somewhat master the art of taming the unruly "bionic" hand while successfully avoiding drastic failures or mishaps.

Of course, an iLimb in itself is a handicap in itself so one needs to tread slowly.

Without surprise, none of these shows or interviews ever went past the "oh this is so inspiring" level, with the amputees showing off their "bionic" arms usually parading them, or maybe intentioning the one or other "move" in "as if" scenarios, while filling Twitter and Facebook with never ending streams of more of the same.

All the while, everyone slowly realizes that an iLimb can survive one full day only when kept out of harm's way.

While we are repetitively told, just how inspiring it is.

And the same is true if one adopts these puppies into one's own body scheme for every day life. The iLimb or other "bionic" hand is, and remains stuck, at the promise level - however, for that type of discussion, it is absolutely great.

Then, the prosthetic hand and one's own body including the hosed arm "become one". You have that "great" "bionic" hand that slowly becomes you, or where you become part of it, as assimilation works both ways, but you never quite go past that.

Believe me, I tried, I was there.

Now here far more than for other aspects in life, the amalgamated whole, the combination, the "Cyborg", will never perform better than its weakest part - and this makes clear why even a pretended or assumed or theoretically combined unity of "bionic" arm and human are so interesting: how much disability can we still sell as ability and for what good?

When I would wear a "bionic" arm as part of my identity, as amalgamated part of my body scheme, and as part of myself, then I would depend on it, always. Of course, as totally integrated body part that prosthetic arm will be exposed to all I do. And I would totally identify with it, as that is how integration into body scheme works.

I would even see to it that I could get a backup model in case the model I use every day fails. After all, I am only me with this bit on myself, and as that it prosthetically "completes" me whereas without it on, I would be "incomplete".

Now, seeing as if the gloves for these hands fall apart within 10 minutes of just washing a car (or less), that would mean that I would refrain from all things that would use up that glove, and always (instead) use my (human) left hand.

That, so far, is only a mental  model - but in this real world, all the people that I know of that actually do use a "bionic" or myoelectric hand on a daily basis (there a number of them) indeed reported medically significant overuse problems of their (human) hand and arm.

So one thing seems to be valid from reflection and anecdotal validation: incorporating a "bionic" arm into your body scheme may very significantly cause you to save that "bionic" arm from damage, and, to accept its absent functional range, which directly contributes to overuse of the other arm.

Even a stump of unilateral below elbow amputees may be, and on any occasion actually is, more functional, than any prosthesic arm, and not only far more efficient than a "bionic" hand, but also quite a lot cheaper. It is not totally free of cost, as an increased use of my stump around the house and for work, lifting heavy objects etc., may cause the skin to require more care. A well built simple heavy duty prosthetic arm also serves as protection in these circumstances, but I never read any author of scientific publications to ever, ever mention that aspect.

So right from the outset, this "adopt a bionic arm into your body scheme" is not so much about enabling me manually or grasp, work or task wise, but, about submitting to an anthropomorphic principle by paying a high price on both sides: we immediately hit the submission / domininance axis here, as the underlying operative sociological main issue.

The people that explicitly or implicitly ask me to do that ask me for the reason that they believe it makes me more human, while the price that I pay (by suffering the consequences) and that society pays (did I mention, expensive) makes them logically less than human.

Secondly, whenever we hang our self and identity onto the perpetual presence of a "bionic" arm, logically and actually, we will have to construct our life, and particularly our activities, to suit that fact. The "bionic" hand then becomes a real constraint as it adds weight, blocks function, and runs up significant costs, is in the way, sucks and fails. With a "bionic" arm as perpetual body part, we will not be rock climbing, or perform other activities that make us sweat a lot (sweat puts the electrodes out of order), that are very cold (cold ambient temperatures can make the battery fail), or that require secure grip strength such as shoveling, or performing other hard work. To put it bluntly, if one wants to avoid being a pansy boy, better stay away from adopting "bionic" hands as permanent body part. Conversely, wearing these will be a great excuse for not even being able to open a pop corn bag.

Thirdly, as a corollary, one tends to (only) do stuff that a "bionic" hand actually can do. Stuff that such a device positively manages to complete. Activities that one can very safely, if not even beautifully, perform with such a "bionic" hand. Those are first and foremost: talking, posing, and secondly, pretending or intending. So one may well show, pretend, and even intend use of a vacuum cleaner, but one will not be able to perform an extensive actual use case for that - I tried, and after 5-10 minutes I sweated and the electrode control went bananas. Biking works - until one sweats as well. One may demonstratively hold a screw - but carrying and mounting over 500kg of furniture material in a real life example will not work, not even with a different prosthetic arm. I know, I tried, I do such stuff, ad nauseam. So you find yourself trapped in a perpetual "demo mode", wearing one of these hands at all times.

Fourthly, one will have to go on a diet. Clearly, when making an iLimb part of my body, I cannot really race my bike extensively, I cannot use it to row a boat, to perform exercises, or to work hard outside, or to help moving or installing furniture. So if I do not pay attention, I will really gain weight.

Point five, I am not ever going to be a "full human" despite bending over backwards to "be one" according to the anthropomorphic principle. Quite simply, a "bionic" hand does not make the disfigurement and disability "less". It just makes it different - at the price of added skin problems, added orthopedic problems, added financial and time wise expenses, and added other troubles such as frequent if not daily device failures. So if ever you had the hope of becoming a human "again" by wearing these "bionic" thingies? Forget that.

Most memorable quote from years ago in our local gas station in a north / eastern Zurich suburb: "excuse me, man, congratulations on your prosthetic hand, it is really well made, one almost does not recognize it as that!". And with that, simply, we can tell money that is wasted.

Consciously not integrating a particular prosthetic arm into one's body scheme and thus avoiding to become a typical "quasi Cyborg", but much rather, an atypical one

I tried incorporating an iLimb into my body scheme, but the results were sobering. See above (I also tried that with a passive / cosmetic arm, where that actually worked a hell of a lot better, but that is a different story).

So one wears a body powered arm. At first that fails, too. But other than my iLimb or similar constructions (where manufacturers pace or delay all the improvements whatever they may be), body powered arm components can be improved rapidly, also by users, themselves. The mindset of wearing a highly technologized body powered arm is that of freebasing activities, terminal devices, and situations. I do not even let the prosthetic arm come close to being in my "body scheme".

I run my terminal device (or even the whole prosthetic arm thing), as it it was a new camera, I try to learn the dials and tricks and tips and settings, the issues and problems and all that real fast, I work hard to be extremely proficient with it, then I drop it and learn a new one, then I switch back, then I do not wear the prosthetic arm for a while maybe, and it goes on like that. There is no body scheme that I bother about. The arm is hosed, permanently, and the best thing I can get is a tool for a thing I want to do, and if the tool is not available then I go try different options or find workarounds.

There, technical proficiency trumps all other aspects, so also restrictive disability insurances or rehabilitation insurances are happy to follow any product lead that is better, lasts longer, costs less and works better. When I sail along the pure function and pure value axis grip wise, insurance funding is with me as that is also what they want: pure orthopedic and manual ability.

A non-adopted prosthetic arm solution is adopted as tool just as fast as it is dropped and replaced with a better one. It is that adoption of the better method or tool that is blocked when I adopt, say, an iLimb into my body scheme permanently.

There, as users of technology, we really can freely "be actually robotic" at least inasmuch as mechanical parts are concerned, without anyone living in the "phantom Cyborg society" (see above) realizing that we actually exploit that technical paradigm to a far larger extent than with the seemingly roboticized hands that generate motor noise and use up batteries. The real innovators in the whole "robot" "Cyborg" arm amputee circus are extreme users of body powered arms, that actively push the technology and that match a range of terminal devices with specific tasks.

Consciously not incorporating a body powered arm gives me a lot of extra freedom, shape-wise.

After all, the most modern and advanced free thinkers invented transhumanism not as a concept that sticks to a human hand shape by all means. It specifically opens up the whole shape arena, and so the prosthetic "hand" shape is one to let go.

Were industrial grippers massively successful were they shaped like hands - hell, we would know that by now.

So we realize that in context of distal below elbow amputation, there is a paradigm reversal: myoelectric arms are outdated, but only a few realize that the actual future is in snug and extremely clever design of mechanical arms.

By clinging, hopelessly, anachronistically, politically, to the "Russian arm" paradigm (today's "bionic" or myoelectric arms are nothing else) one perpetuates an old fashioned view of modernism.

One clings to a type of technology whose many inherent restrictions and problems pose constraints that exclude relevant improvement. To follow that path of the "Russian arm" was a dream in the Fifties. Just as driving a V8 pony car was. That dream is stuck now. It brings up warm memories, it is an expensive dream to really live, it is anachronistic, it does not win actual competitions or real races any more - it is quite simply and aging concept. A dead horse, as we know.

Now, in cars, we replace V8 with modern motors and electrics and in a twist of fate, the reverse is true for body powered arms: very well built, material wise sophisticated prosthetic arms with clever body powered technology are far ahead - not just that: they go places where no "bionic" arm ever goes. The result of the "Cybathlon" showed an older gentleman with a slow pace present to the public what a younger group of users of the same technology would never waste their time with: massive superiority. Cybathlon participation is not en vogue or even considered by real users of proficiently performant body powered arms: but on Facebook, one guy showed a photo of a dead wasp he had caught midflight with his body powered prehensor. The work I or others do with body powered technology is entirely and totally unparalleled and impossible to produce with myoelectric arms. And this was sky clear to most of us all along. Only some academics, they did not believe it. I think they still do not get it. Paradigm reversal here has taken place already a while ago.

Of course, great technology requires a mature mind - just as cars with great power require a mature driver. As user of fringe technology, you will eventually learn that society discriminates you no more and no less, if you wear a hook, or gripper, or TRS prehensor, or Becker hand, or cosmetic / passive hand, or no prosthetic arm at all, than when wearing a "bionic" arm. It took me a while to figure that out. The smirks may vary but their tension remains the same. Bottom line is, it does not make a difference. Society is not intellectual, does not manage "understanding" but remains lost in folk tale and magical thinking space.

Real success incorporates a more comprehensive view of the term "aim".

With a body powered high tech arm, even with an occasional use of "bionic" technology, or fooling around with this or that mechanical piece on my arm, if anything, one widely opens up usage domains. Just don't sell your soul for any single one of these.

My particular choice of prosthetic arm does not tie me to such a restricted usage domain.

Conversely, I make my arm work for new endeavours and thus expand my activities, and so I rode up the Stelvio pass (bike adapters: here, here, here), I swim a reasonably good fly, I go skiing (heated arm, skiing pole adapter), I also 3D print test samples and then build new stuff (well, why do I have to link this here, browse to the 3D section yourself and do all of us a favor!).

The shifting shape, due to wider ranging and far more powerful prosthetic options, of my hosed arm, allows my brain to adapt, obviously to a wider range of options there. So, mental flexibility, bitch!

Of course, I can also drink a beer, coffee, tea, or juice and read a newspaper with my "bionic" hand - but I can do these things so much better without a "bionic" hand - and on top, restricting myself to just that would feel like an awfully restricted life.

So why would I adopt a restricted "bionic" hand into my body scheme if all that happens once that is completed that the "bionic" hand dies one of thousand deaths? What if the "bionic" hand getting adopted really is, on a larger scheme, some type of paradigm suicide? Once the loud and forceful media appearance and pretended power of these "bionic" hands is perceived as "imperative", and once I admit this "imperative" into my own domain, where that "imperative" then drowns, scatters, rips itself apart, explodes, stalls, dies, and once it is clear that I was never, for once, hiding my requirements from the public, would that not count as clearly suicidal? I personally would answer that, if a societal but dumb idea finds itself correctly termed "dead horse" once again, it cannot possibly die again. It just got buried another time around - just until someone finds it necessary to warm it up again and give it yet another go.

But as I found out, for me, it is the big things that count. Not the little things.

And with that, society's choice of prosthetic arm technology (they chose the electric non-functional type) clearly diverges from my choice (highly functional, mechanical) in an attempt to define the composition of the Cyborg. As the person to have my preference extensively tested, documented, justified and internationally validated, I am right and the others are wrong, un-negotiably so. Which is a view on technology that makes me a fan of Alex Roy.

So really, the debate of Cyborgism boils down to whether I as the user, or a hysterical uneducated public spearheaded by media and "academics", get their say in what technical parts are to be used for the contemporary prosthetic arm play-alike of quasi-Cyborgs.

It ultimately is a pure question of who has the louder mouth and who has the harder elbows. The debate when a really useful new prosthetic arm/hand comes along is not, like, really happening; there, all we see are (at best) shifts of amputee independence, no improvements.

[1] W. Barfield and A. Williams, "Cyborgs and Enhancement Technology," Philosophies, vol. 2, iss. 1, p. 4, 2017.
[Bibtex]
@article{barfield2017cyborgs,
  title={Cyborgs and Enhancement Technology},
  author={Barfield, Woodrow and Williams, Alexander},
  journal={Philosophies},
  volume={2},
  number={1},
  pages={4},
  year={2017},
  publisher={Multidisciplinary Digital Publishing Institute}
}
[2] J. H. Hughes, Citizen Cyborg: Why Democratic Societies Must Respond to the Redesigned Human of the Future, Westview Press, 2004.
[Bibtex]
@book{hughes2004citizen,
  title={Citizen Cyborg: Why Democratic Societies Must Respond to the Redesigned Human of the Future},
  author={Hughes, J.H.},
  isbn={9780813341989},
  lccn={2004022971},
  url={https://books.google.ch/books?id=Acp-ZdLCLFMC},
  year={2004},
  publisher={Westview Press}
}
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