Heritage Snapshot: Part 68

David Warner, MD, PhD, known as Dave by the children he served and admired, is a 1995 graduate of Loma Linda University School of Medicine. He entered medical school with a wealth of knowledge about computers and a valuable network of contacts with people in aerospace, the military, and entertainment. Warner matched existing computer technologies with healthcare in ways never before conceived. A participant in Loma Linda University’s MD/PhD program, Warner focused on the physiological basis of information processing. Warner first transferred technology from a NASA subcontractor to healthcare with the VPL DataGlove. The DataGlove had fiber optics in the fingers. When the fingers were bent, movement was sensed by the fiber optics and translated to numerical values by a computer. He first used the DataGlove in medical applications to measure the frequency, duration, and intensity of Parkinson’s tremors. It provided objective, quantifiable measurements and comparisons for neurologists to use in determining a Parkinson’s patient’s response to therapy and time. Then Warner applied this technology to help patients who could no longer talk turn hand gestures into speech. By using sign language, a patient using the DataGlove could generate a computer-synthesized English-speaking “voice” to communicate with his caregivers. If the patient’s loss of speech was sudden, resulting from a stroke, for example, Warner programmed the computer to “talk” from simple hand gestures, such as holding up one to five fingers for five different computer-synthesized voice messages (“I’m thirsty.” “I need to go to the bathroom.” “I’m having trouble breathing,” etc.). The DataGlove was then used to permit rehabilitation patients wearing it to move virtual objects around on a computer terminal. They could pull virtual levers, turn virtual wheels, and move virtual boxes around on the monitor screen, developing hand–eye coordination and fine motor skills with very little strength. Recovery from injury often depends on a set of repetitive exercises. The rigors of rehabilitation can be difficult, especially for children. Interactive interface technology, such as virtual reality, fosters motivation because patients are having fun. “Without exception we find that this technology engages the mind to interact. And that’s a great thing,” says Warner. “In rehabilitation the problem a lot of times is not that we can’t rehabilitate them physiologically. It’s the psychological capacity that blocks them. They don’t want to do it. They’re depressed. They’ve lost function. But now we give them something fun to do. They think they’re having fun—we know they’re rehabilitating.” Warner set up a research laboratory, dubbed “The Center for Really Neat Research,” and later, the Human Performance Institute—all while completing medical school. His work was mostly unfunded, out-of-pocket, low-cost efforts, using his own computers and self-designed software, or computers and software he borrowed from sympathetic sources, including volunteer programmers. This software converted electrical impulses and other inputs into computer commands. For example, the software would read the electrical activity created by movement in a patient’s muscle. Fast-changing voltages were received by digital signal processors and determined how much energy was being expended in relation to time. When the computer detected a change in voltage, specially designed software converted those changes into computer commands. The harder the muscle worked, the greater the differences in the voltages. During each session the patient was wired up for a variety of activities so that different muscle groups got a chance to work out. The system provided a mechanism for the patient’s improvement to be monitored objectively and documented. Mike Fredholm, one of Warner’s adult patients, acknowledged that the technology could increase the amount of time he would spend exercising his muscles. However, Warner and those who saw this technology’s potential felt frustrated. “It’s not sanctioned, supported, or refundable by insurance,” said Warner. “We’re able to make a difference, but unable to use it routinely.” But that didn’t stop him. Warner was on a mission to do the most possible good with any available resources—leading by example. He was leading the effort to alter patient outcome and outlook whenever possible by using interactive information technologies. The first quadriplegic patient to benefit from Warner’s creative mind was a baby girl named Crystal Earwood. Crystal was only 12 months old when she was paralyzed from the neck down in a terrible automobile accident. When Warner saw the baby for the first time six months later, her condition touched him deeply. She was a conscious, bright baby, just lying there, unable to move. Warner was motivated to design a computer system for Crystal. By using a bioelectric sensory band around her head, above her eyes, Crystal was able to move a Happy Face around on the screen of a computer terminal. In short, her eyes became her hands. It was the first time little Crystal had been able to do anything by herself since the accident. But it was a major achievement. One small step for Crystal—one giant step for the profoundly disabled.