Cambridge, Mass.
'It's extraordinary that we live in this day and age with all our wonderful modern technology, and still we have shoes that give us blisters," says Hugh Herr, with more than a little incredulity and perhaps even fresh anger at this lack of progress. "Shoes are one of the oldest devices that exist across the human timeline and it is just staggering that we haven't figured out that problem."
It's a remarkable observation, on reflection, in more ways than one. Footwear and its discontents are more or less inevitabilities most of us take for granted. Also, Dr. Herr lacks biological legs below the knee.
He is fitted with bionic prosthetics of his own invention, known as BiOMs, with his trousers rolled to display what he calls their "machine beauty." Dr. Herr (pictured nearby) is the director of the Biomechatronics Research Group at the Massachusetts Institute of Technology Media Lab and a world leader at the frontiers of limb replacement and rehabilitation.
Here in a glass-walled office on the mezzanine off his huge two-story campus workshop, Dr. Herr explains that he is trying to create machines that rival or are better than the real thing. His team is building "what I hope will be the most comprehensive human improvement lab in the world," he says. "As we step into the future more and more people will have parts of their bodies that are designed, are part of the built world," he says. "What's intriguing is that the designed part of the body can improve in time, whereas the normal body, the biological body, degrades in time."
Cerebral and intense, Dr. Herr, who is 48, walks with a natural and even jaunty gait, almost a bound, which would be impossible with conventional prosthetics. His advance was to design a robotic lower-leg device that uses a complex onboard system of microprocessors, environmental sensors, control loops, springs, struts and muscle- and tendon-like motors to emulate natural locomotion. The BiOMs bend like joints, flex like muscles. Automatically, reflexively, they adjust mid-stride to different speeds, slopes and terrains, and recycle energy, as if they're flesh and bone.
The hardware is astonishing enough to watch in action, all sophistication and elegance—machine beauty, indeed—but Dr. Herr is not satisfied with artificial limbs any more than he is with shoes.
"Often when a person has a disease or goes through a traumatic injury and they come out of that experience with an unusual body or an unusual mind—I'm not going to use the word 'disabled'—they're told too often from the medical community that the current state of technology is the best, it need not change, accept it," he says. "Often that state is pitiful."
Instead of labeling humans as broken, he continues, the industry ought to apologize for its limitations. "Humans aren't broken. They're never broken. The technology we provide for rehabilitation is broken."
Dr. Herr learned as much as a young man, several generations ago in terms of treatment. A wunderkind climber, he and a friend were caught in a whiteout blizzard in 1982 while attempting to summit Mount Washington, infamous for its dangerous weather swings. After nearly four days in subzero wilderness they were found with severe hypothermia and frostbite, though not before one of the rescuers, a young man named Albert Dow, died in an avalanche.
"That's beyond a regret, I don't know how to articulate that level of regret," Dr. Herr says, but it is the only thing he would change if he could—although after months of failed palliative measures he became a bilateral amputee at age 17. He was enraged by the functionality, or nonfunctionality, of his first crude plaster of Paris prostheses. As a teenager he had been indifferent to school, but now he had a cause, and he went on to pile up degrees from MIT and Harvard, win multiple patents for his prosthetics work, and land his MIT post.
Dr. Herr's past is an obligatory focus of media profiles, but his ambitions clearly are larger and more radically new than any kind of personal self-determination would suggest. His goal is no less than to transform society by erasing the distinction between technology and anatomy and therefore limits on human flourishing; the only limits he acknowledges involve imagination and the laws of physics. "What's known as disability is a human-rights issue," he explains, albeit one that "can be solved with innovation."
Some two million Americans live with limb loss, but Dr. Herr notes that "about half of the U.S. population has some form of cognitive, emotional or physical condition. We're talking about a lot of people who could be repaired. . . . A person with paralysis wants to walk. A person who cannot see wants to see. It should be the right of every human being to move freely, to touch, to feel, to live life without profound depression, or profound delusion."
In that sense Dr. Herr's work may be a rebuke to the influential strain of techno-pessimism that asserts that technological progress has flatlined. The claim is that the Information Age has not led to advances like those of the Industrial Revolution, such as electrification or penicillin or the automobile, and that more recent gains have been virtual rather than material. The George Mason University economist Tyler Cowen calls it the "great stagnation," while Peter Thiel, among the most successful of Silicon Valley entrepreneurs and investors, has argued that "We wanted flying cars, instead we got 140 characters."
Even if progress has been inadequate, Dr. Herr declines to join the doubters. "Technologists, if they're any good, are always frustrated at what seems to be the snail's pace," he says. Yet "there's a technological arc that climbs upwardly with increasing slope with time" and "It's inconceivable to me and everyone else what the world's going to look like 20 years from now." He adds: "Often the predictions are too conservative."
Technology will push in more practical and useful directions, Dr. Herr thinks, as scientists come more and more to "intensely ignore" disciplinary boundaries. His own research already occurs at the creases: There's biomechatronics—biology and mechanical and electrical engineering—but also neuroscience, mathematics, machine learning, tissue engineering and even aesthetics and fashion design. Except, he adds, "we're actually building body parts and not just covering body parts."
The other untapped resource is, well, ourselves. "The human body doesn't do meat-and-potatoes engineering," Dr. Herr says, and its workings are "non-obvious. . . . We spend a lot of time modeling how a quote-unquote normal healthy body works—morphologically, structurally, dynamically," he explains. The BiOM never could have been developed in the abstract: "We would be lost if we couldn't steal from the cookie jar of nature."
Dr. Herr does acknowledge that his aspirations amount to "an enormous undertaking, both technologically and economically." Gesturing at his BiOM, he says: "For example, for this ankle there's been tens of millions of dollars invested, and it's one joint."
In every other sector of the economy, technology makes life cheaper, easier and better. New treatments and devices usually do the last thing in that trio, sometimes the second but rarely if ever the first, thanks to the peculiar U.S. methods of health-care financing.
Dr. Herr says that the typical response of insurers and government is to "do everything possible not to pay for" advanced limb replacement, but he also argues that "there's a certain class of technology where it's so good, where if you look at the total cost over the lifetime of treating a patient, the technology actually profoundly mitigates the price tag."
The major cost of treating people with limb amputation isn't the prosthesis but the painkillers, as bad prostheses lead to limping and thus physical stresses and fatigue, and ultimately to arthritis and chronic back and other pain. If the person can't return to work after an accident or live independently, or falls into drug or alcohol abuse, the average cost to the state works out to about $5 million to $8 million.
"The fly of the cost is the prosthesis and the elephant is all these secondary disabilities," Dr. Herr notes. The company he founded in 2006 to manufacture and commercialize bionic limbs and joints, iWalk, has helped more than 600 people, and the number is growing. An Ohio workman's-compensation program has enlisted iWalk to fit injured workers with BiOMs because the program's actuarial data show that every patient who goes back to the job will offset the cost of nine who don't. When patients, doctors and payers realize that these tools could lead to trillions of dollars in savings—his estimate—"the age of bionics, which is just beginning, will spread like wildfire."
Dr. Herr is now poised to bring to market a bionic knee akin to the BiOM ankle. He is also working on better sockets, which he says a thousand out of a thousand amputees will say is the No. 1 immediate problem in prosthetics. The "very hard but very, very dated problem" of attaching technology to the body mechanically is what prompted his observation about blisters.
One next-generation solution, he believes, is a bionic skin, "as if it's made specifically for you—in fact it is made for you, for that location on your body." The skins, "rich with sensory information," would breathe, move, stiffen and relax with movement and meld seamlessly with the body. The applications beyond prosthetics include mobility devices like knee braces for the elderly or injured, or larger exoskeletal robots that augment biology, or even "humanoids."
The next generation—"at some point in this century"—will involve what Dr. Herr calls "extreme interfaces between synthetics and biologics, between materials like titaniums and polymers to skin and bone and muscle and nerve." The idea is to create a direct electric connection with the peripheral nervous system so people can manipulate robotic body parts as if they were natural. Then potentially machines can also exchange information with the brain "to reflect the sense of touch, to reflect perception, to reflect heat, pain, all these things that encompass human feeling."
The science of extreme interfaces is "very exciting" but "very rudimentary," Dr. Herr says, "but the problem is tractable and will be solved." And think of the possibilities: "Imagine a world where we could actually fix people. They lose a limb, we give them a limb back. It may not be biologics, it may be synthetics. A world in which a person is seeing-impaired, we can fix it. A world in which a person has severe depression, we can fix it. . . . We're going to have the opportunity in this 21st century to satisfy that human right."
Mr. Rago is a member of the Journal's editorial board.
A version of this article appeared July 13, 2013, on page A11 in the U.S. edition of The Wall Street Journal, with the headline: The Liberating Age of Bionics.
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