Bionic Brains and Beyond
The National Spelling Bee of 2023 started out like any other, but controversy enveloped the contest when Suzy Hamilton, an 8-year-old from Tulsa, emerged as the new champion. Contestants had been getting younger for years; that was nothing new. But midway through the event it was discovered that Suzy was—in the words of one commentator—”amped.” At the age of 4, suffering from seizures and severe attention and behavioral problems, Suzy had received an experimental new treatment: a neural implant that prevented her seizures and helped her to focus. As it turned out, the device also appeared to make her a prodigy at memorization, as her parents and teachers soon discovered.
Was this youngest-ever winner fully human or was she part machine? Was it fair for her to be in a competition with peers made of mere flesh and blood? The lawsuits soon hit the courts. A new battle over civil rights—over the very definition of the word “human”—had begun.
Sounds far-fetched? It isn’t. Over the next decade, new implantable technologies will fundamentally alter the social landscape. We are fast approaching a milestone in the eons-long relationship between human beings and their technology. Families once gathered around the radio like it was a warm fireplace. Then boom boxes leapt onto our shoulders. The Sony Walkman climbed into our pockets and sank its black foam tentacles into our ears. The newest tools are creeping still closer: They will soon come inside and make themselves at home under our skin—some already have.
These tools aren’t sinister. They’re being created to solve real problems. Simply put, prosthetic limbs help people move, and neural implants help people think. But these days the technology can solve our problems and then some. Solutions may not only erase physical or mental deficits but leave patients better off than “able-bodied” folks. The person who has a disability today may have a superability tomorrow.
In my new novel “Amped,” these implants create a class of superabled people whose capacities destabilize society at large, sparking a full-on civil rights movement. The book was inspired by watching super-enabling technologies creep into society through those who need them most, such as amputees and those who suffer from blindness, deafness or serious brain injuries. But such enhancements will almost inevitably become elective, and then we will face some tough decisions. Should we have an unlimited sovereign right to upgrade our own bodies? Or should such decisions be heavily regulated?
The conversation may be jump-started as early as this summer, on the glaring international stage of the Olympics. The poster boy for our superabled future is Oscar Pistorius, an increasingly famous South African sprinter who happens to have had both of his legs amputated below the knee. Using upside down question mark-shaped carbon fiber sprinting prosthetics, called Cheetah blades, Mr. Pistorius can challenge the fastest sprinters in the world. He is currently just one race away from representing South Africa in London.
Whether or not to allow Mr. Pistorius to compete is no longer the issue. In 2008, he was barred from competition by the International Association of Athletics Federations. He responded by putting together an all-star team of scientists who successfully lobbied to have the decision reversed. If Mr. Pistorius can qualify (he is currently the only South African to have beaten the Olympic qualifying time of 45.30 seconds for the 400-meter), he will become the first amputee runner to compete in the Games.
The scientists convincingly argued that the advantages of Mr. Pistorius using his Cheetah blades were offset by the disadvantages of being a double amputee. But prosthetic technology is quickly improving to a point where the balance could tilt the other way. The prosthetic of tomorrow, made of advanced materials like carbon fiber and titanium and controlled by brain implants that could provide intuitive neural control, may well be a living, breathing limb, complete with a sense of touch and the ability to react intelligently to a changing environment. In the highest echelons of sports, merely “able-bodied” athletes may no longer be able to compete effectively.
Such scenarios are likely to play out in a range of fields. Some people will consider the superabled to be cheaters, using technology to break the rules. Others will see them as tenacious contenders with the audacity to overcome grave obstacles. Regardless, the world will soon bear witness to an epic realignment of the relationship between “disabled” and “abled.”
The issue is especially relevant to the thousands of military families now dealing with an influx of amputees returning from Afghanistan and Iraq. In many cases, young and physically active veterans are looking beyond fitting in, considering instead how to wring the maximum amount of performance from an array of prosthetic tools designed for tasks ranging from sprinting to ice climbing.
The goal for many amputees is no longer to reach a “natural” level of ability but to exceed it, using whatever cutting-edge technology is available. As this new generation sees it, our tools are evolving faster than the human body, so why obey the limits of mere nature?
While researching the lives of such amputees for my novel, I spoke to DeWalt Mix, who at the age of 27 was in a devastating motorcycle accident. Two years after the accident, he made the difficult decision to have his severely injured left leg amputated below the knee and replaced with a prosthesis made of carbon fiber and steel. Lamenting that no prosthesis can duplicate the adaptability of a natural limb, he says, “If I can’t have it closely mimic the capabilities of the original, then I want something much better.”
Industry is taking notice. In February 2012, Nike teamed with orthopedics company Össur to introduce its first sprinting prosthesis, called the “Nike Sole.” Endorsed by the amputee triathlete Sarah Reinertsen, the carbon fiber blade is featured in commercials that focus on overcoming adversity. “I don’t think about it,” Ms. Reinertsen says in one of the spots. “I just run.” Other mainstream sports and fashion companies are sure to follow suit.
Prosthetic limbs aren’t the only technology undergoing a renaissance—neural implants are also rapidly maturing, promising to provide mental augmentation rather than physical.
Neural implants, also called brain implants, are medical devices designed to be placed under the skull, on the surface of the brain. Often as small as an aspirin, implants use thin metal electrodes to “listen” to brain activity and in some cases to stimulate activity in the brain. Attuned to the activity between neurons, a neural implant can essentially “listen” to your brain activity and then “talk” directly to your brain.
If that prospect makes you queasy, you may be surprised to learn that the installation of a neural implant is relatively simple and fast. Under anesthesia, an incision is made in the scalp, a hole is drilled in the skull, and the device is placed on the surface of the brain. Diagnostic communication with the device can take place wirelessly. When it is not an outpatient procedure, patients typically require only an overnight stay at the hospital.
Existing neural implants treat serious conditions. Cochlear implants can deliver sound collected from an external microphone directly to the auditory nerve and into the brain. According to the U.S. Food and Drug Administration, over 200,000 people already use cochlear implants world-wide. Other neural implants act as “brain pacemakers,” performing deep brain stimulation to treat people with Parkinson’s disease. Yet others can be trained to recognize when epileptic seizures are about to occur and then deliver stimulation to the brain to stop the incipient frenzy of brain activity.
But research is going further.
In the future, it will be feasible for an implant to recognize almost anything. For instance, it could detect inattention. In response, the implant could stimulate the brain toward a state of focused attention. Recently, researchers at the Institute of Neurology at University College London stimulated the brains of human subjects to push the brain toward beta band frequencies associated with focus to study the effects on motor processing, with the hope of helping those with Parkinson’s disease. In an elective setting, a user with this type of implant could potentially choose to stay focused on command, while constantly strengthening circuits of the brain associated with concentration.
The neural implant of the future also could strengthen neural pathways associated with physical tasks. It could recognize “practice” movements and deliver stimulation to associated neurons to help your brain learn faster. Initial users would be people learning to walk again after having a stroke. But you could just as easily be swinging a tennis racket or a baseball bat. Or hitting perfect jump shots. With help from a neural implant, it might be possible for athletes to hone their skills incredibly quickly.
The next generation of assistive technology is making headlines every week. The journal Nature recently reported on two paralyzed individuals who were able to command a robotic arm to make reach-and-grasp movements by thought, using only a Braingate neural implant. One woman had enough dexterity to pick up a cup and take a sip of coffee through a straw. In Boston, a blind man recently visited the Massachusetts Eye and Ear Infirmary and had a lens wired directly to his optic nerve. He is now able to see colors and read large print text. And last month, a woman paralyzed from the waist down walked the London Marathon in 17 days, wearing a ReWalk motorized exoskeleton.
The technology can give us brains and brawn. All we have to do is let the devices under our skin. So who will reap the benefits? At first glance, this appears to be just another advantage waiting for the wealthy. Maybe, but the early adopters will be those with disabilities. Not because they have money but because they have a lot to gain and are willing to face the risks inherent in new medical technology. Alleviating chronic seizures or debilitating tremors isn’t some kind of greedy leg up for a person with a serious disability—it may mean the difference between life and death.
But once the people with serious disorders are treated, where will the technology go next? The Census Bureau estimates that about 13% of the population in the U.S. is over the age of 65. That is roughly 40 million people who have lost physical and mental capacity through the natural aging process. Regardless of their resources, they will be keen to regain their powers.
The dissemination of advanced implantable technology will likely be just as ruthlessly democratic as the ailments it is destined to treat. Meaning that, someday soon, we may have a new class of very smart, very fast people—yesterday’s disabled and elderly.
The sudden appearance of “super-abled” people could put new and unforeseen strains on our society. For example, what happens when mentally sharp, physically capable retirees return to the workforce by the millions? When your child is the only kid in her class without an implant and she has the lowest test scores to prove it, will you agree to put her under the knife? Will professional sports teams let superabled people play, or is that cheating? Would you hire one over a “regular” person? Should a person be required to reveal the presence of an implant? Or will that just open the door for discrimination?
Humanity has been co-evolving with technology for more than 100,000 years. Together with our tools, we are on a grand, generation-spanning trajectory. Whether we like it or not, the next step of this evolution is on the near horizon.
—Dr. Wilson’s latest novel, “Amped,” will be published by Doubleday on June 5. Find him on Twitter: @danielwilsonPDX.
Source: Wall Street Journal.
