Tomorrowland (9 page)

Dobelle is marshaling these dots like pixels on a screen. “We’re building the patient’s map, layer by layer,” he explains. “The first layer was individual phosphenes. The next layer is multiples. We need to know where his phosphenes appear in relation to each
other so a video feed can be translated in a way that makes sense to his mind.”

Some phosphenes look like pinpricks or frozen raindrops. Others appear as odd shapes: floating bananas, fat pears, lightning squiggles. Of course, the use of the word
appear
is misleading, since the phosphenes appear only in the patient’s mind. To the sighted, they are completely invisible.

Dobelle sits in a wheelchair beside the patient. His left leg was amputated a year ago after an ulcerated infection in his big toe spread out of control. Because being in a wheelchair makes it hard to dig into his pants pockets, he favors T-shirts — “the good kind” — with a chest pocket to carry his keys, a couple of pens, his wallet. His shirt is so weighed down that it sags from his neck, drooping cleavage-low. He has a patchy, unkempt gray beard. His forehead is high and wrinkled, and his glasses are thick and wide.

“Are we ready for multiple phosphenes?” asks one of the techs.

Dobelle nods his head.

So smoothly has the morning been going that while we’re talking, the techs allow the patient to take control of the keyboard and begin stimulating his own brain. This isn’t standard operating procedure, but with the excitement, the techs don’t stop him and the doctor doesn’t notice.

Suddenly, the color drains from the patient’s face. His hand drops the keys. His fingers crimp and gnarl, turning the hand into a disfigured claw. The claw, as if tethered to balloons, rises slowly upward. His arm follows and suddenly whips backward, torso turning with it, snapping his spine into a terrible arch. Then his whole body wrenches like a mishandled marionette — shoulders tilting, neck craning, legs twittering. Within seconds his lips have turned blue and his deadened eyes roll back, revealing bone-white pupils, lids snapping up and down like hydraulic window shades. There’s another warping convulsion, and spittle sails from his mouth. Since the doctor’s in a wheelchair and the techs seem hypnotized, I rush over and grab him.

“Call 911!” one of the computer techs shouts.

But the doctor yells back: “No!”

“Lie him down,” cries the other. “Get him some water!”

“No!”

My arms are under his, trying to steady the weight. His head snaps toward mine, and I take it on the chin with the force of a solid right cross. We’re now close enough that I can count the wires going into his head. I can see a faint scar where a surgeon’s saw cut a hole in his skull and removed a chunk of it like a plug from a drain. Finally, the techs move to action. They’re up and struggling to unhook the patient from the seeing machine — but really, what can they do? It’s in his brain. I’m pretty sure he’s going to die in my arms.

2.

William Dobelle likes a good Wright Brothers story. Like how the first plane the Wright brothers built didn’t have a steering mechanism, that it merely went up and down and straight. Or if you look at a plane these days you won’t see their names on the side. Instead there’s Boeing or Airbus, but even so, you know these makers are merely historical recipients of the Wright stuff, just as you know that your voting privileges are somehow owed to Thomas Jefferson. Of all the Wright Brothers stories, Dobelle likes the one about Lieutenant Tom Selfridge the best.

The Wright Brothers ran low on money. They built their airplane, but they needed more cash for further experimentation. A lieutenant from the US Army showed up for a demonstration, and after watching Orville pilot around for a little while he said, “That’s great, now take me for a ride.” So Orville strapped Selfridge into the passenger seat, took off, and promptly crashed. Crashed! The plane was wrecked, Orville was in the hospital for months, and Selfridge was killed — yet the brothers still managed to land a contract for a military flier.

The doctor treats this story like a talisman. Its moral — with
great risk comes great reward — has been an inspiration for him during the past thirty years, since 1968, when he began working on an artificial vision system to restore sight to the blind. The moral was there in the 1970s, when he went under the hot knife of surgery and had his own eye slit open to test the feasibility of a retinal implant. It was there when he looked over the work that had been done on the visual cortex and realized the only way to create a visual neuroprosthesis was to slice through the skull and attach an implant to the human brain. It was there two years ago, when he decided to skirt the Food and Drug Administration by sending his patients to a surgeon in Lisbon, Portugal, because he knew there was little chance the US government was ever going to give him permission to experiment on humans in America.

There was one lab rat, however. In 1978, shortly before the FDA passed the last in a series of medical device amendments that would outlaw testing a visual neuroprosthesis on a human, Dobelle installed his prototype into the head of a genial, big-bellied, blind Irishman from Brooklyn named Jerry.

“When my grandkids meet a blind guy with a brain implant,” says Jerry, explaining his participation in Dobelle’s experiments, “I wanted them to be able to say, ‘Let me tell you about my grandfather.’ ”

For years the prototype sat in Jerry’s occipital lobe, largely unused. Back then Dobelle’s concerns were infection and biocompatibility. When neither turned out to be a problem, he edged the research forward. Over the years, Jerry’s visual field was mapped, but his implant never produced true “functional mobility.”

Functional mobility is a bit of jargon defined as the ability to cross streets, take subways, and navigate buildings without aid of cane or dog. For the past forty years this has been the goal of artificial vision research. But Jerry’s not there, instead he’s caught halfway between sight and shadow.

When hooked up to a video camera, Jerry sees only shades of gray in a limited field of vision. He also sees at a very slow rate. It helps to think of film. Normal film whirls by at twenty-four
frames per second — but Jerry sees at merely a fifth of that speed. The effect, Dobelle tells me, is a bit like looking at snapshots in a photo album through holes punched in a note card.

Patient Alpha, on the other hand, has the full upgrade: the Dobelle Institute Artificial Vision System for the Blind. Because the system has yet to be patented, the doctor is cagey about specifics. He won’t say how many electrodes are inside the patient’s head, though by my count the number is around 100. Other changes have been made as well. Instead of Jerry’s one implant, the patient has two, one in each side of his head. Materials as well have been updated, and the power pack and signal processor made portable. But the biggest difference is that it took Dobelle twenty years to work Jerry up to any sort of vision. Patient Alpha, meanwhile, got out of surgery a month ago.

3.

William Dobelle was born in 1941 in Pittsfield, Massachusetts, the son of an orthopedic surgeon. Ask Dobelle how he got into this game and he’ll say, “I’ve always done artificial organs; I’ve spent my whole life in the spare parts business. I just inherited it from my father. By age eight, I was doing real research.”

Which sounds like hooey, until you check the records. He applied for his first patent, on an artificial hip improvement, at age thirteen. He was in college at fourteen and hooked on the challenge of artificial vision by eighteen. It was also at eighteen that he dropped out of Vanderbilt University to pursue independent research on visual physiology, supporting himself as a Porsche mechanic.

In 1960 he returned to school, earning an MS in biophysics from Johns Hopkins. This time he covered costs by selling scientific ephemera: iguana gall bladders and whale hearts that he collected in South America. He finished his PhD in physiology from the University of Utah and became the director of artificial
organs at Columbia Presbyterian Medical Center. By 1984, he had a lab of his own.

Located in Hauppauge, New York, near the center of Long Island, Dobelle’s lab sits inside one of the largest industrial parks in America. All around are the offices of high-tech whatevers — Aerostar, Gemini, Forest Labs, Nextech, Bystronic — housed in grim, squat warehouses accented only by trim lawns and odd awnings. Most of the buildings have them, these decorous afterthoughts: green shingles attached to aluminum siding, Spanish tile against cold stone. “We don’t have an awning,” notes Dobelle, proud of his austerity.

Walk inside and you’ll see a carpet so thin it could be cement. The furniture in the front offices looks anonymous, wood-veneered, bought by the pound. Behind the offices is a larger workshop — the home to the breadwinners of the operation.

During his tenure as a spare parts man, Dobelle built hiccup suppressors and erection stimulators and pain inhibitors. Right now, there are 15,000 people running around the world with his inventory inside their bodies. The workshop is currently used to build lung, spinal cord, and deep-brain stimulators. Since he’s never wanted to be beholden to anyone and thus never accepted venture capital, these devices pay the rent so Dobelle can pursue his real goal: artificial sight.

“It doesn’t come cheap,” says Dobelle, rolling himself into the workshop so I can get a look. We pass a machine shop — drill presses, lathes, saws of all varieties, tools hung on pegs and others left out among the dust and metal filings — then out onto an assembly room floor. In the center, separated from the rest by long sheets of heavy plastic, there’s a clean room for delicate procedures. And against a far wall stands an ancient computer, weighing two tons, complete with a punch-paper tape input and a Teletype output. It measures ten feet wide and seven feet tall.

“What is that for?” I ask.

“That was the first artificial vision system, the one I built for Jerry. It’s my past. Thirty-four years of work and $25 million.”

4.

The cost has come down quite a bit. According to a printout Dobelle hands me, the price tag for curing blindness is now around $115,000:

Visual Prosthesis System:
$100,000

1 miniature camera mounted on eyeglasses

1 frame grabber

1 microcomputer

1 stimulus generation module

2 implanted electrode arrays with percutaneous pedestals

3 sets of rechargeable batteries and 1 charger (customer is responsible for replacement batteries as needed)

5-year full warranty (not including travel or freight)

5 years of annual follow-up examinations in Portugal (not including travel), unlimited telephone consultation

Evaluation of patient:
$2,000 psychiatric evaluation/all other testing

Hospital expenses:
$10,000

Miscellaneous expenses:
$5,000 airfare to Lisbon, hotel and food for one week (2 people), miscellaneous (such as taxis)

The first person ever to receive this bill was Patient Alpha. His given name is Jens — pronounced
Yens
. Twenty-two years ago, at age seventeen, while nailing down railroad ties, an errant splinter took Jens’s left eye. Then, three years later, this time fixing a snowmobile, a shiv of clutch metal broke free and took out his right.

Jens lives in rural Canada, where the winters are brutal. He makes his living by selling firewood. Working alone, he splits logs with the largest chain saw currently available on the market. During the high season, he’ll manhandle 12,000 pounds of wood
in a day. He helped his wife deliver six of his eight children at home, without a physician or midwife. Jens dismisses the whole hospital birthing process as rapacious big business.

Starting from scratch and without the aid of sight, Jens designed and built a solar-and wind-powered house and pulled his family off the grid. In his spare hours, he programs computers, tunes pianos, and gives the occasional concert. For a blind man to give a classical recital requires memorizing whole scores — a process that can take nearly five years. To cover his surgery, Jens gave quite a few recitals.

5.

Back in the lab, I’m still supporting Jens’s weight. He’s panting and jerking. Every pore on his body leaks sweat. His neck has gotten too slippery to hold, so I’ve jammed my right hand into his armpit. I can feel the throb of his axillary artery. His heart is beating. Thankfully, he’s still alive.

Over the next five minutes, the gasping subsides. Respiration returns to normal. The full-body twitch stills to the occasional flutter. Soon the grim rigor of his hand relaxes, his fingers merely stretching now, as if reaching for the far notes on his piano.

Dobelle’s glaring at the techs.

“What happened?” he demands.

“He was overstimulated.”

“Yeah, I know that.”

Beside him, Jens’s head bobs once and then again. Slowly, motor control returns. He stretches his arms as if waking from a long sleep.

“What happened?” echoes Jens, his voice a low, percolating gurgle.

“You had a seizure,” says Dobelle.

“I wha . . .”

“A seizure. Jerry never had one, but it was always a possibility.”

“I wha . . .”

“You’ll be fine,” says Dobelle.

“For what I paid . . .”

“What?”

“For what I paid, I better be.”

“OK,” says Dobelle. “I think we’re done for today.”

6.

Later that night, Dobelle calls to explain. His voice is balmy, preternaturally pacific. “My surgeon is the world’s foremost expert on epilepsy. When someone’s having a seizure, you don’t lie them down or give them water — they could choke. I knew he would be OK.”

And the next morning, when I walk into the lab, Jens is OK. He’s back at the table, amid another round of testing. He doesn’t remember much of the seizure, but he remembers seeing the phosphenes.

“It was wonderful,” says Jens. “It is wonderful. After eighteen years in a dark jail, I finally got to look out the door into the sunlight.”

“Are you ready for a little more?” asks Dobelle. In his hand is a pair of oversize tortoiseshell glasses. The left lens is dark, and affixed to the right is a miniature video camera: black, plastic, and less than 1-inch square. The wires that yesterday ran from the laptops are now plugged into the camera. It’s time to see if Jens can see.