The Hype and Hope of Prosthetics

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I don’t think it’s a zero sum game at all. I think open approaches can only improve the care given to patients and ultimately lower the costs to manufacturers and providers by making it easier for them to provide better care. I think you can raise the bar for everyone.

You wrote in your IEEE article that a chasm exists between what people think is available in prosthetics and what's actually available to consumers. How has the media played a role in that?

I think it has a lot to do with the medium. When you’re talking about short news stories, blog entries online, or short TV news pieces, there’s not a lot of time to tell a complicated story. So everything gets reduced to a sound bite, and the nuances get lost. The media has focused on the gee-whiz part [of prosthetics]. If somebody was able to control signals that someone interprets as being controlled by thought, then the story automatically becomes about a thought-controlled arm.

In 1965 the New York Times ran a story about the Boston Elbow program when it was first announced that said, “New prosthetic limb allows amputee to control limb by thought.” So we’ve been hearing the same story since then, and we’re still hearing it. While I’m very excited about what's happening on our project right now, when I go to the prosthetist later today, I’m still going to be getting work on this hook that has a patent from 1912.

So how would you like to see the story change? How should the media report on prosthetics?

Since that 1965 story, what we’ve had is a focus on the concept car. We very much have an analog in the auto industry. There are concept cars, and there are production cars. I would like to see not only a focus on what the production cars look like, but also a realism about what they do. There have been stories about the myoelectric prostheses delivered at Walter Reed, one of which I have, that would make you think those hands already do everything that the DARPA project is seeking to accomplish. And they don’t. I would like to see the press focus on what people can actually get in the clinic. Remember that these myoelectric prostheses are still only used by fewer than 5 percent of the upper extremity amputee community. So we’re talking about inflated claims about an early adopter niche community. We should focus not only on what the production stuff actually is, but also what is actually delivered to most of the patients.

Do you think pop culture or science fiction contributes to the prosthetics hype?

I think that one reason the news stories go the way that they do is that news is entertainment, and in a brief period of time you tell a story that has a happy ending. I think that happy ending is informed by—let’s face it, not many people know somebody who’s lost an arm. You may know somebody who’s lost a leg, like your aunt who has diabetes. Most of what we know about prosthetic arms doesn’t have anything to do with prosthetic arms. It’s science fiction imaginings. It’s the Six Million Dollar Man, it’s RoboCop, it’s the Terminator, it’s Luke Skywalker and Darth Vader. So when we imagine what we think is possible or what should be possible, we’re connecting these science fiction representations, and it seems like all this stuff should be done already.

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