January 2018 – Before I Forget…

January 27, 2018November 9, 2018

No Cab for Annie

Attempting things that no one else quite understands – and when you are just groping along yourself — has its certain virtues. There are few second guessers since even the objective of the project shifts daily. The key element that guided us when creating the CPR simulator was only “Will it work?” But even that criterion was flimsy. The fragility of the concept in those early days led us to what answered only by what we thought it could eventually do…A dream defined. The system, as I described designing with the CPR doctors, would have two screens, and a full-sized manikin which would lie on the ground. A light pen would allow the user to interact with the screen (much as touch screen does now). If the screen asked you to touch a random list of actions in the correct order, you did so with the light pen and the computer recorded your answers.

As the CPR Learning System took shape, it required two separate and distinct activities coming together.

1. It was imperative that we create a manikin ( mannequin anyone?) which was realistic enough to allow the student to practice moves in the right places, and to look for signs of life or ascertain the need for CPR. To accomplish this we had to take an existing manikin, used by current classes, and embody sensors to tell us that the student actually knew what to do, and could actually perform it on the manikin.

The realistic vinyl manikin used by American Heart in its CardoPulmonary Resuscitation (CPR) classes had been supplied for some years by a Norwegian company, Laerdal, which had a good business supplying these relatively inert teaching manikins to the American Heart Association, the Red Cross, various rescue units, and a fair number of hospitals. All of these organizations gave classes on the inert Resuci-Annie manikin, which did have lungs that inflated, a neck that would tilt back, and a breastbone that would provide realistic resistance to the student. Because they foresaw a new business blooming, the Laerdal people were quite cooperative with getting us manikins to rip apart and “sensitize.”

The sensors we implanted in Annie not only had to read the precise actions of the rescuer, they had to communicate that to our Apple 3 computer, by means of a special card we built to insert into that small inexpensive machine. (We had to design in a reasonable cost for these in from the start). The location of the hands had to be sensed, and the depth and duration of compressions had to be timed to make a graphic pattern on the second, non-video screen. The lung expansion was followed with piso-electric fabric, and the student was inferred to be checking for breath with a photo-electric sensor that assumed nearness of the students face or hand checking for breathing. We would have to do a similar set of sensors for a baby manikin, except we also used mercury switches to read position of the head (down below the feet when freeing an obstructed airway) and the neck position when the student/rescuer was blowing breath into the baby.

2. The interactive Video screen had to present realistic situations, and also the learning and testing segments, in one concise package. Jane Sallis, who I had worked with before at Texas Instruments, put in an incredible number of days on the CPR video disc. I told her every day we wasted in getting this done we should imagine dead victims piling up on our doorstep (; I was a fairly crude motivator, but she later admitted it worked). We had to plan perfectly for each of the 54,000 stoppable frames, which would then be given sound by our interactive audiotape, which we had pioneered at an earlier stage. In those days, any videodisc required exquisite planning because an original high quality videotape had to be sent to Japan by one of the three nascent videodisc makers, and all of their early processes took over two months. If this all sounds like it was high speculative, it was. But first, we had to get the support of someone like Sony, which we hoped would be able to market psychic benefits of being involved with a national rescue effort. It was at that point merely a demo interactive videotape with a wired manikin and pieces hanging out the sides. Mostly it was held together by sheer belief.

As I say, it was critical that we enlist a leading-edge partner with a videodisc operation, and I was the one who had to sell this all to Sony. For that I had to take a trip to New York City and the SONY building on 59^th Avenue to sell this off the wall project. The prototype equipment and its trial programming had been iffy when I left and I was wary of prematurely blowing this opportunity, and thought I might stall it a bit, but Jane said that is what opportunity looks like – something no one else understands or wants and that you step up for.

I will always remember taking this kludgy conglomeration of spit and bailing wire electronics from Dallas to the slick, spiffy executives at Sony in Manhattan. The manikin – Annie – in its large shipping crate, and the tape player we connected to the computer to manage the interactive experience with the sensitized manikin, all this in an awkward stack of shipping crates which I could put on a small platform dolly and get from here to there: Airport to hotel with a big tip for the yellow cab to put these crates in the trunk and the back seat. Then the next morning 17 blocks from the hotel up to 59^th Street…except that the rain bucketed down as I stood in front of the hotel waiting for a cab, and the cabs never stopped. I figured if I rolled the stack out to a busier street there would be more chance of getting a cab. It continued to bucket and I continue to be ignored by cabs full of happy dry people who wondered what in the hell I was rolling along the street, parting streams of water now…walking toward a 10 am appointment with Sony that would determine the future of the CPR Learning System, and a lot else.

17 blocks and no cab would even turn down any street I happened to be on. “Just get a cab,” someone at Sony had told me as I sat in Dallas a few days before. 17 blocks crossing streets up to my ankles in running water, pushing the heavy stack of equipment no one wanted to pick me up with. Finally, a block away from the Sony building, a yellow cab stopped beside me. It would take more time to load and unload the stuff than push the stack this last block. “Fugetabout it” I said in my best New York accent.

It was one of those days which began with disaster, and as if responding like true champions – every piece of electronic equipment that had sloshed for an hour through the honking downpour mid-town Manhattan…every piece worked perfectly. The Sony people had seen about everything in the world and New Yorkers have seen everything in the world on their streets, and none of them had seen anything like it. They could understand what this interactive videotape system would look like when it used their videodisc. Sometimes, and just a very few times, you can find people who are ready to take the same leap you are taking, and understand exactly what you are doing. I credit Dan Harris and several more of those whose job it was to introduce the videodisc to the U.S. with “getting it” immediately, and pulling others in from all the floors to see this crazy system that was perfect for showing off the interactivity of their videodisc.

That was a successful meeting, though I was dripping wet through all of it and could have been electrocuted at any moment of my demonstration. I believe they got a truck to get the stack of stuff back to the hotel. That was the success of the day, and they quickly agreed to get our videodisc made and wanted to take the system to several shows where they were showing off the videodisc. That was a few months out, and required a lot of shipping, but those first shows such as the Consumer Electronics show in Las Vegas, drew a lot of interest for Sony, and for us. They had these little forums of people to ask questions in side rooms, and I was basking in the general appreciation and interested questioners when I got blindsided.

“Why do you have to use a young girl for the manikin? That looks extremely sexist to me…”

I looked out and there were several women, of all ages and diversities, nodding their heads at me.

“Well, the Laerdal people have done studies, with male manikins and mustaches…and the response is uniformly low for them and totally, uniformly – from men AND from women – they are more comfortable with the young girl. “ I hoped I was convincing enough with this… but I was not.

“That’s a bunch of male chauvinist pig crap done by male chauvinist sexist marketing types…I don’t see we should believe this crap at all.”

A lot of female heads were nodding in support and grumbling louder too. I had never expected I would be on the verge of a protest march from having tried to do good in the world. So when the grumbling subsided for a second, I tried one last thing.

“I would like to tell you the real reason, the original reason for having the manikin be a young girl…”

“Because men like the idea of working on her…”

“No,” I said, “It’s because of her father.”

The crowd quieted, but the questioner remained standing, hands on her hips. Her hunched glare said Go on.

“Mr. Laerdal had a doll-making company in Stavanger, Norway, and was fairly successful at it. He had a summer home on a lake back in the Norwegian mountains where he took his large family and their friends on holidays. One summer day they were all swimming out into the lake and someone shouted Annie, and in a few minutes they dragged Annie, Mr. Laerdal’s lovely young daughter, up on the beach, and everyone tried to revived her, but she died there on that beach, that day. Mr. Laerdal was so aggrieved that he made a life-mask of his daughter Annie, and later decided to make a manikins to teach lifesaving. He closed his doll-making company, even though it was very successful, and dedicated the rest of his years and his fortune to making manikins in Annie’s image so that thousands – or maybe millions — of other lives would not be lost in that way. So that is the one we use…in a way…that’s Annie there today.”

The crowd was very quiet now, and began to shuffle away from the standing questioner, many leaving the room without further comment. She finally stood alone in the group of empty chairs, which sort of ended my presentation.

“So OK,” she said, “I’m not going to clap…but that sounds like a reason.”

Needless to say, the help of Sony was invaluable. They gave us one of their first four videodisc players to come into the country, and supplied all the videodisc processing once we had the original videotape. Later, these pieces would have to be programmed to operate together in one seamless experience. However getting to that point, riding like the wind on hypothetical constructs, was anything but seamless.

January 19, 2018March 3, 2018

A Sweat Sandwich in Indian Country

Not only are heroes made-not-born, I’ll swear many of them are partial heroes by accident. Someone walking the rails snatches a meandering child from an onrushing train. Quick thinking, perhaps. Maybe reflex. But the act only seems heroic if there was a split-second involved, when the option of most people would be to watch dumbstruck. In fact, my own bar is much higher. Heroism would, to me, require a few extraordinary choices leading to the dangerous situation, near despair by any normal person, and one person’s rise to action in the face of clear and distinct peril.

On the battlefield we had a clear assessment of such situations: sweat sandwiches and shit sandwiches. (Guess which is the most perilous.) If a few people were shooting at you and you could manage to make them go away, or get out of the area where they were shooting at you, that would be called a sweat sandwich, a random situation that you could probably extricate yourself from with known methods and assistance at hand, such as digging a hole where bullets could go overhead, and having other people or planes or bigger guns to shoot back. The report of action over your radio would be “sweat sandwich developing. Need some rounds on them half a click NW of us.” A click, by the way, is 1000 meters and a tribute to the fact the US military joined the rest of the metric world mid-twentieth century, while US civilians, almost alone in the world — kept the bizarre old feet and inches based from yore on the length of some of the King’s physical appendages. A sweat sandwich, then, was dangerous, but probably survivable with high energy and competent use of your own weapons (and the assistance of friendly weapons whenever possible).

A shit sandwich, on the other hand, was dire. There were usually a lot more people shooting a lot more stuff at you from all around you. Shit sandwiches mean possibly survivable with all of the above sweat sandwich remedies plus sheer unadulterated luck of these kinds: (1) Deep mud between them and you, instead of between you and your route out, or (2) some more attractive alternative to killing you, like the adoring crowd of local prostitutes who suddenly distracts them from their absolute possession of all your exits, or, (3) just a few times, it was the crazy, unexpected, demonic energy of a guy like Cage. Cage was this Marine from West Virginia and he never made more than private because his temper was hair-trigger and applied equally to all. He’d learned to control it except in a few cases when we were being attacked and some advance of the Viet Cong had put us in a shit sandwich.

One of my lasting images was of 6-foot Cage standing silhouetted against explosions, over a previously unseen ravine which was now literally pouring attackers out onto our hilltop position, and there was Cage standing in the middle of it all, frustrated with how slowly his rifle dropped them, grabbing bodies and throwing the smaller Viet Cong attackers with their rifles and grenades, and tossing them like bad rubbish with one arm and then the other, back down the ravine, collapsing the attackers onto each other like dominos. Cage was legend among the troops of the battalion. Though he might not easily blend with polite society, he was at home with Marines in Viet Nam. You might say Cage specialized in shit sandwiches.

True, the situations in which heroism arises are usually random. You don’t set out in the morning to become a hero, by anyone’s definition. Most Marines I knew just tried to do their jobs, and to be as dependable as possible to each other because, when all rationales are done, all the men I saw and respected were basically doing their jobs for each other. You occasionally hear football players on successful teams say they are playing hard for each other. I subscribe to that, and as an officer there was another level: of being loyal to your men. To watching out for them. To make sure they had beer anytime beer was to be had. To defend them against the idiosyncrasies of the military bureaucracy tangled in the battlefield, where orders came from somewhere to go somewhere you would not go in your right mind, and to do with no supporting reason whatsoever. I’m saying that there are a lot of mistakes made when the air of uncertainty is the only air you breathe all day. On one coastal operation, I sat in on a conference between our battalion commander and the head of a Navy SEAL team. Apparently there were tunnels that went down from a peninsula we were taking and some of the Viet Cong were thought to be escaping via tunnels that opened underwater at high tide. Our battalion commander was in the process of ordering the SEALs, ranking far below him, to swim into those small dark tunnels with guns and grenades waiting and intercept the Viet Cong.

“Can’t really do that, sir,” said the SEAL Team leader, respectfully but resolutely.

“Well, by God, sailor, that’s an order.”

“Sorry, sir, we can’t manage that one.”

The battalion commander was flabbergasted. He knew the Seal was right. Of the few VC intercepted, none would be taken alive in the dark tunnels, and there was a high probability that many of these highly skilled undersea technicians would have their lives wasted for nothing.

“You can’t do your job? That’s your job, isn’t it.”

“Well, sir, we’re a little short for this sort of thing.”

What I had just heard was someone with no power in the system standing up for his team of men against someone with great power over him. The battalion commander mumbled something about how this was going to be reviewed with his Chief, but he already knew he would lose this one. It didn’t absolutely need to be done, and this low ranking head of Seal Team was not going to let his men — some about to go home and thus “short” (for short-timers) — walk into a dark, inescapable pit of butchery. This was a kind of career heroism, (with his career at high risk) and the men who saw this organizational courage from their leaders became incredibly dedicated followers. Of course there were no medals handed out for this type of heroism.

The supply of medals often seemed merely a matter of supply and demand. In the areas where the fighting was constant and deadly and where the smoke rarely cleared, there were occasional allotments of medals that sat around until some lull of a few days where everyone was basically tired of fighting. We fired at each other across deep gulleys and then one side started to file down the pointed tips of the 7.62 mm NATO rounds that everyone used. The VC used AK47s and could use the same rounds as ours (or a Winchester .306 round, if you must), so they could use captured ammo. The filed down round would mash out if it hit you and tear your shoulder off instead of going through it. No one liked the filed-down rounds so our Civil Affairs guy white-flagged into the gulley and both sides decided not to file down again unless the other did. That would be called an extempore Rule of Engagement.

And the pause got better. The VC disappeared into the populace with their local girlfriends and the Marines retired to secure cantonments for some beer and steaks which magically reappeared, sometimes before ammo resupply. A net was strung up and we played jungle volleyball, the loose rules of which allowed any kind of hitting of the ball with your hand and any type of grabbing, kicking, or tripping your opponents under the net. Depending on how much and what kind of action there was, a certain quota of medals seemed to appear. They seemed to want to write up bronze stars and a smaller portion of silver stars to motivate the troops. Often, of course, a person had rotated out when the approval came through. But there was often some maneuvering for the quota of medals, especially within Officer corps.

In one of those lulls I was tasked in my secondary occupational specialty as communications officer to go set up the optimal command post for a peninsula we were in the process of taking. I say in the process because as it turned out, the helicopter deposited me in an area I was told was secured, and as the blades flop-flopped away into the sky, I looked around and did not see a welcoming committee. Actually, after looking around a bit, I decided not to blurt out my position. Apparently we had not taken this area yet. How interesting. Now the question was: had anyone else taken it? Was I being watched from the bushes, a curious intruder into a peninsula full of enemies? I decided I’d better make my way back to the beach, and then perhaps find my battalion inland. I was in Indian Country, as we called any area we had not secured.

I was in Indian Country and it was too quiet. Either they missed my exit from the helicopter or, more likely, they were just watching me to see if there were more like me around. The best I could do is act like any action from them would cause stuff to rain down like hell on them. I pseudo-confidently made my way about half a mile to the beach. On the way, there was a 500 lb bomb crater courtesy of the Air Force, and in the bottom of it was a cow. Its rear end had been blown away, and it was lying there moaning. It looked at me with big brown eyes, almost pleading. I thought for a moment the best thing I could do in this world was to put the cow out of its misery with my .45, but I reached for it, and then thought better. Noise is not good. Maybe they were watching me or maybe not, but a blast from my .45 would change the game, and not in my favor any way I could guess.

If you can tiptoe in the jungle, I tiptoed back to the beach, and then worked my way down in the shadows of beachside trees until I heard an American voice. “Who goes there?”

Now that was a question. I tried to remember a radio code name for this flank of the operation. “Mystic Crystal Bravo!”

“Wrong” said a voice from a wall of sandbags. And then the helpful, “That was yesterday.”

“Hey, I was in DaNang yesterday,” I said.

“That you, Hon?” I recognized it as the voice of the Mustang S-3 operations officer who just happened to be walking the lines.

“Yes, sir,”

“Get over it, Hon.“ He was still behind the sandbag wall. Then I realized they all stayed down because the VC were probably right behind me. “What the hell were you doing in there?”

“Chopper dropped me in there…Setting up new command post.”

“Oh…too bad. We were planning to take those couple of clicks but something snarled. Guess the pilot didn’t hear.”

“Or me, sir.”

“Well, Hon, we better get you into a briefing now, because now a hell of a lot of people want to know what’s out there.”

The few staff officers a battalion had grilled me and then the Commanding Officer and the Executive Officer grilled me and they showed me maps (one of which had never been given to me) and I tried to point out where I’d been and what I’d seen, which was not much of anything but a cow.

One of the onlookers was Lieutenant MacDonald, who I knew but never did know what he did, and he pulled me aside after one grilling. “We’ve got three more silver stars for this operation. You should get one for reconnaissance behind enemy lines.”

“It was a mistake. We didn’t know it was Indian Country. I’m not that brave, believe me.”

“But you were there, and you got out with vital information.”

“Information that there didn’t seem to be anyone there?”

“That’s valuable. And the way you got through enemy territory, that’s heroic.”

“It’s a joke.” I said. “It’s a big screw up.”

“But they probably would give you the Silver Star. There’s a case for it.”

Sometimes these things flicker past your head for second. A Silver Star would set you up for life in the military: it would always be foremost in consideration for promotions and — as the experienced Marines did in a sort of conspicuous understatement — you could wear only personal combat decorations in a slim but telling line above your uniform shirt pocket. The thought flickered, and then I could imagine being laughed at. I could imagine laughing at myself. I didn’t want a military career anyway.

“Give it to Cage.” I said.

“You don’t want it?”

“Naw, give it to Cage. Give it to him while he’s alive. There’s not a soul who’ll disagree.”

I don’t know if Cage did get that Silver Star, but he should have. He was certainly the hero I would never be and besides, I’ve since felt a little more right with the world if I did dodge a phony Star that was possibly tossed at me.

January 7, 2018February 1, 2018

Tactile Graphics…and a Russian Redux

With Ixion becoming somewhat known for medical simulators, we displayed our ERCP (Endoscopic Retrograde CholangioPancreatography) simulator — which we had recently shown in Sydney, Australia — at a St. Louis show for medical technology. At our booth, we were asked to take a break to talk with someone from Ethicon, the largest division of Johnson & Johnson. That someone turned out to be the CEO. He had played with the ERCP simulator. He was looking for a company to build a laparoscopic simulator for the innovative new “keyhole” surgeries that were being used by surgeons to remove gall bladders by watching their inserted tools on video monitors.

We told him what we do is not easy, and that we would require a major commitment from Ethicon to follow through the tangled pathways of building a simulator. He said Ethicon had made 11 billion that year and that he could follow this through. I said I would like to work with Ethicon on this, and we agreed that I would contact him in the next week. All very professional, very business-like, while I was shaking in my boots!

We discovered that Ethicon was also talking with another company, a leader in making flight simulators which had excellent engineers and a significant track record in successful projects. Luckily, I had recently been granted a patent in exactly what Ethicon needed, and we agreed to do a feasibility project to demonstrate how the simulator might work. This gave us a small infusion of cash, and another impossible project to complete in a few months.

I had adopted this feasibility project approach for a couple of reasons. I did not want to do a 30 page proposal and have the ideas stolen while giving the project to a brother in law who said he could do the same thing. Other companies were doing this, spending godawful hours and ruining families generating proposal after proposal which went nowhere. If someone was interested in our participation, I suggested a short meeting to understand their needs, and then I gave them a price for a feasibility study. It would include a complete development plan with costs and time. I often built-in a 5-minute video “demo” envisionment…Managers could usually get five minutes with other decision makers to get more buy in for a final, large, package. And the deal was, when they had paid for this feasibility study, they could take the information and the demo to whomever they wanted. However, because of the time invested and the tool they could show about to get concensus on the project, we were never thrown out on the street. We created added value in this process. Some of the other companies which generated 30 page proposals got a lot more projects and grew much larger than mine. But only some of them. There were a lot of burnouts and heart attacks in those companies as well.

The question of how to create a vision of a future reality is much like advertising agencies or movie makers doing a creative pitch. The difference is that, with projects like Ethicon wanted, we did it without knowing exactly how we would make the technology, or exactly how it would all work together. Movie people and ad people know how they will get the concept completed. We didn’t. We were only vaguely familiar with software and hardware that could possibly achieve a realistic simulation. Therefore the exclusive invitation was nice, and the bit of cash helped our tiny company survive, but the next step was when we proved to Ethicon not only that this realistic laparoscopic simulation could be done, but that we could do it. Scary.

Ethicon had some urgent need, however, because they were selling surgical equipment for this new laparoscopic procedure, which was minimally invasive. This meant it left only a few small scars, and the healing time was within a few weeks. People with their gall bladders removed could be back to work the next week. Everybody wanted this procedure, but no one knew how to do it. It required operating with tools inserted in trocars in the abdomen, and the surgeon had to operate remotely with long sticks holding needles and scissors and graspers. Some of the finest surgeons who operated in the open body could never get the hang of operating so remotely, both because of their limited vision the inserted television camera, and in the limited “chopsticks” feel they could get through the special instruments.

For this reason, Ethicon had to be responsible for teaching the surgeons. And short of operating on humans for the first time with no prior experience, the surgeons could only gain their first experiences in pig labs, operating on live pigs which were anesthetized for the procedure. Ethicon had a history, selling tools and thread and other operating room necessities to surgeons since the Civil War. Now Ethicon and U.S. Surgical were selling the laparoscopic tools, grippers and scissors and curved needles, plus the trocars, the tubes that went through the abdominal wall, usually three of them. The trocars would also accommodate a video camera, which gave the surgeons their remote visualizations.

Ethicon’s real problem, in this booming new minimally invasive surgical business, was the animal labs. More than one animal rights group had real issues with surgeons practicing on pigs. It was the idea of it, being unnecessarily cruel to animals – even though they were anesthetized as well as any human in surgery, and their remains were disposed of in highly hygenic circumstances. These same people seemed to have no problem with bacon, and within limits, to animal experimentation for scientific purposes. But the surgical pigs seemed to these protesting groups to fall in an inhumane category of wasteful killing for the profits of big medicine. The problem came to a head when one of the U.S. Surgical pig labs was bombed. It occured after hours and no one was killed, but it was a dynamic protest that made headlines, and a dilemma for Ethicon. They had to teach doctors in order to sell equipment. The public wanted more minimally invasive procedures, and a whole market area was wide open if they could train without pig labs.

So, once again we had a project with psychic benefits of training for lifesaving, and one which was highly important to Ethicon to waylay criticism for the pig labs. Even developing a simulator showed the public that they were responding in a responsible way to a major social problem.

I decided to pull out all the stops with the feasibility study, and create the model for it for the actual demonstration. This would make our final proposal far more understandable and believable. It was not the first time I proceeded as if I already had contract, and put in far more effort than we were being paid for. This was one of those projects that could be worth it. We were going to have to put half a spherical background in virtual reality, and that abdominal cavity had to look highly realistic. We had Dr. Noar, who had worked with us on the ERCP do the shooting in precise circles, so that our videodisc demo could skip down up and down video “rings” when the camera went in and out and pan in real time if the camera was swiveled. The final simulator would have to have angular moves by the camera, but these rings were good enough for a demo.

To get pig footage in these somewhat precise rings, I devised metal school protractor, and soldered it to a screen which would be sewn onto the pig. My son Galen actually soldered the protractor to the screening. This was a bit slap dash, but we did get the footage we needed to index on a videodisc, and at the demo, change their parameters of perception. The surgeons they had at the demo could actually maneuver and search within the 180 degree sphere we had created.

That the people at Ethicon saw something they had not imagined could be done, even in our simple demo, moved them to offer us the contract. They were sure that another company could not do it, and I had the patent which described it. It was my first 7 digit contract…well into 7 digits in fact. Now we had to figure out how to do it. I mean really figure it out…Showing a realistic background that can be maneuvered within wasn’t doing half the job. Now we had to create virtual organs to place inside the anatomical cavity, and we had to invent our own digital instruments that a surgeon could hold and believe it, and a torso with trocars which made them believe what was inside. Moreover, we found that they unanimimously wanted the organs to react to the instruments not only visually, in real time, but tactilely.

TACTILE? GRAPHICS? 3D PICTURES THAT YOU CAN PULL AND STRETCH AND SEW AND CUT? Sometimes promises get out of hand. It was 1991 and no one in the world had done this. Not games, not the space program, no one…gulp. Visual realism can be achieved with 30 frames a second, although the 3D models in real time required a “dynamics engine” to achieve something that looked like face-morphing in the movie “The Terminator” but the Silicon Graphics computers that created them worked all night on one movement. Ours had to be done in real time. But that turned out to be the easy part. To feel what you grip and cut, requires 1,500 frames per second because our sense of feel is so refined.

Our programmers began simply, trying to create simple shapes in space, so that a stick could feel the virtual outlines and ascertain what shape it was. The only problem was, there were no experts in feeling virtual shapes. But there were experts in feeling. The blind were experts in telling shapes by feeling.

Somehow we found a computer engineer attending the University of Washington…who was blind from birth. When we brought him in to test our shapes by touching them with a stick, we had been woeful failures, taking swipes in space and trying to logically space the figure in our mind from where our sticks hit. We couldn’t tell a square from a circle from a triangle. And then the blind engineer took the stick. Tap tap. “Square.” Another tap, tap. “Triangle.” And tap, tap, tap. “Circle.” Nothing quite like expertise.

So we had a team of about twenty people, mechanical engineers, software engineers, electrical engineers to design small printed circuit boards for each instruments, plastics engineers building a torso with mechanical switching when different instruments were used…everyone trying to design an experience more realistic that anyone had seen in simulation.

And then there was Russia. Yes, Russia – but not the Soviets. Eight years later I was headed back to a new and different Russia. It turned out that our realistic anatomy of a human would be a little harder to get than that from a pig. We would have to have a human body open long enough to take a sequence of individual still pictures, high resolution, that were located exactly against each other so that the virtual camera moving in an infinite combination of angles and depths seem a totally realistic and seamless experience to the surgeon. Problem was, American lawyers could not find a way to justify having the abdominal cavity left open for even an hour, and we though we would need two or three hours, photographing hundreds of positions in a circular grid, to achieve even one virtual patient. And we aimed for 4 or 5. Luckily, Ethicon had some business going with the newly democratic Russia in 1993, and they enlisted the ex-surgeon general of the army to guide our activities. It was discovered that under certain circumstances, Russian medicine would allow up to 8 hours for a medicinal drip, which theoretically left an incision open. That’s all we needed, we would have a camera on a shaft with special lenses, and shoot through that tiny incision.

Of course, the last problem was precision. The surgeon had to be able to return to exactly the same spot with his trocar camera, and for that we had to invent a stand for the 3D circular grid. I got a film crew I knew that built innovative frames for shooting, and in the spirit of true groping we went to the butcher shop and got about twenty steaks. We lined a shooting box with meat, so we could try to design a holder for the camera that allow precise locations to return to, especially during shooting, where the hundreds of pictures would be digitally sewn into the realistic background. Ethicon saw that precision mechanical engineering of such a stand to create a 3D circular grid might be right in their wheelhouse. Free of charge, their manufacturing engineers designed and built a very precise protractor frame, in effect a sort of reverse sextant, a world of sophisticated engineering away from the little protractor my son Galen soldered to the wire screen which was sewn to the pigs abdomen a year before.

We practiced on a pig and got excellent registration of each inside photo. Having now seen robotic prostate surgery, wherein the surgeon in a 3 hr operation can stop and rest and return to exactly the same spot, and knowing Ethicon worked later with the Da Vinci folks, I strongly suspect the connection. I’m actually proud of it. I’d developed the shooting frame for one kind of precision, and if it now serves another, that’s great. The world moves forward.

So we packed up for Russia and I studied my little 30 Days to Learn Russian book, and we were off in a film crew caravan, through Frankfurt airport and on to St. Petersburg. We were taken to the top hospital in St. Petersburg, which was dimly lit and overall, fairly humble by US standards. The operating room had two stories of glass windows to make use of natural light, and the vital signs consisted of a nurse holding each patients pulse and reporting on it every few minutes. Our film-shooting structures were built to surround the patient and rigidly support our futuristic camera holder, which was lowered over the patient. However, It turned out that film processing was not that dependable in Russia at the time, and with that amount of precision involved, I decided to fly the first film photo rolls to Helsinki, process them overnight, and then call the team in St. Petersburg so they could adjust the photos for the best resolution.

The Ethicon rep in Helsinki arranged for to meet me at the airport, take the film to the processor, and then we could look at it in the early morning before I caught the next flight back to St. Petersburg. I looked at the photos and made the assessment that the grid should start about 2 centimeters closer to the tissue for best effect. We could waste a whole week of shooting if I was wrong. Then, the Russians refused to let me back into the country that morning but I made an impassioned plea with my 30 days of Russian (which also allowed me later to read the names of Russian ships in Seattle from bona fide Cyrillic). Another wait of a few hours and perhaps a few Russian medical favors cashed in, and I was free to go back to the hospital.

We did get the footage in an ardous 4 days of shooting hundreds of tightly registered photos. When I was about to go through Russian customs with my photos in lead packs, the border guard said we would have to open them up and have them x-rayed. I swear this was the big square jawed Russian in a heavy overcoat that eight years before had denied me the hotel I reserved, and sent me to another for the good of the Soviet state. Anyway this time I said Nyet, Nyet, Nyet and the Ethicon people got the ex-surgeon general and they kept this from being an international incident.

And it worked. After another year’s effort, we turned the project over to Ethicon and they showed it around. Apparently the Ethicon CEO who enlisted us and who had maintained faith in a group of ragtag innovators from Seattle (though probably no one should have) presented the system to a group of Japanese surgeons visiting Ethicon, and got a standing ovation from people who know their technology. Also, our programmers wowed the top-notch SIGGRAPH conference in San Francisco with what we called Tactile Graphics. Echoes of cool cool cool buzzed through the whole Valley for a day or so. That’s the way you want these things to end.

January 4, 2018November 9, 2018

Speaking of Peru

After 4 months teaching English in Manizales, Colombia, and a few more weeks seeing Equador, including Quito and Guayaquil, we ended up in Lima, Peru. It was winter in South America and being almost a thousand miles off the equator, Lima had a slightly snippy season. Another thing about Lima made it chilly (- but not yet Chile). An atmospheric quirk brings the cold Humbolt current up the Pacific Ocean from Antartica, just about non-stop. At a point in Peru, the Humbolt Current hits a southerly current bearing down from the Equator plus some hot desert winds from northern Peru. This creates an almost perpetual fog for most of 300 days a year. That place, where the major fogbank hovers, is Lima, the major city in Peru.

There is a local joke about why Lima resides in a perpetual fog bank. Apparently the conqueror Pizzaro had flashed his muskets and cannons and subdued the local Indians. The Indians had little use for wars and mostly fished the Pacific and farmed the countryside. Pizzaro was standing in one of the pensive poses he used for statues, all bejangled with armor and thinking about where they should build the imperial city of Lima. Why not ask the local Indians? They live here, they would know the best spot. So they asked a few of the tribal leaders where the best spot to build a city would be. The Indian leaders confabed for a moment and then, holding back laughter, both pointed to the same spot. Pizzaro had not been around all year, thought it was a nice piece of land, so and ordered the city of Lima built in that spot. The Indian laborers were laughing insanely as they carried out Pizzaro’s wish, and they were always pleased to laughter again, for all their lived, when they passed the cloud of Lima where all the fancy Spanish doings, balls and ceremonies, were going on within the cloud shroud.

We visited the local Centro-Americano school there, and I was asked to give a few classes. Someone said I should go see the Embassy about giving lectures in the major cities. As it turned out, they did want to send someone around to show the branches they cared about them, and so it looked like I was it. They gave me a South American Honorary Doctorate so it looked like I knew something, and left it to me to come up with the topics. The level of English I would speak was 4, which meant simple sentences and about 1000 words and lots of gestures and acting out what I was talking about. A podium was a hinderance to this kind of walkaround speaking, so I usually jumped down from the podium and walked up close to the first rows. Especially when there is no sound system, one does better to get as close to the action as possible.

Sometimes you have to fumble through your past to dredge up a connection for the present. Since the needed to come up with press releases for these two-night visits to major Peruvian cities, I had to think of topics people would like. One was “The History of the English Language.” Now little did they know that that was the only “C” I ever got in graduate school. The tombs of dreary middle English poems and sermons had had a sleep inducing effect on me, I guess. But then no one here knew that I was hardly an expert. Dr. Hon was the way they put it in the newspaper. The other subject was one I knew a little about from talking with my friend Dale at the UCLA film school. I showed them about how to tell a story with close-up and panning and tilting and cutting with understood inference, like seeing a lion from afar and then instantly cutting to his snarling mug. This sort of movie apparently terrified aborigines who had never seen film, but most of the audience would know that this was a visual language, so I called the second talk “Cinema: The Existential Language.” I have no idea what that title meant, but it sounded good in the press release.

So off we went across Peru, Brenda and I riding in nice train coaches now and being met by the Mayor or a town of a few million people and going out to dinner with he and his wife and staying at the grandest hotel in town. The Mayor and his wife would show us the newspaper press release and I was amazed to be the very guy in the picture (, who would be talking about his “C” subject and his Existential Language).

This is definitely the way to travel. We were in Cuzco, an ancient Inca city, and I was told that I was the first American since Robert Kennedy to speak in that auditorium. That fresh in my halo, we took a side trip down to Machu Picchu and stayed in a small 12 room hotel right in the ruins on the Andes ridge. We climbed the terraced mountains and traveled all the surrounding trails by which fresh fish had – centuries ago — been brought by runners from the Pacific. Their Inca rulers had resided in this city hidden from viewers below by the angle of the slope up, and by the cleverness of the ancient architects. The stones fit perfectly together in a way the historians could not account for with the crude tools they had then. Many believed they had been helped by alien wanderers from the skies. They even had the world UFO convention in Machu Picchu one year. Obviously travelogs talk about this, but I should too. Most of the water had to be carried to a high point in Machu Picchu, so that it served various functions as it flowed downward through channels. Highest was for drinking and cooking, and then the animals could drink it at another level. Then the same water was used for washing clothes and further down, to water the crops. It was probably repeated 1000 times across the ancient world, but here in Machu Picchu you could see the simple utility of their city planning.

At night, when all the tourists had gone home, we wandered back into the well-preserved ruins, in the Sierra light at evening. Llamas occasionally frisked in and out of stone doorways. And somewhere back in the city, a dishwasher off for the evening sat playing an Indian flute.

It was an addictive way of life, but the truth was we were almost broke and anything we earned here would last about a day in the States, so the attractiveness of all this was actually becoming a trap.

Back in Lima, I tried to establish contact with David Ward, who had behaved more responsibly than I, got his PhD, and was now the head of the English Department in a small college in Oklahoma. Before we left he said that if he got the job then perhaps we could find one for me. It was time to start seeking our way out of South America. In 1971, this was not as easy as dialing up on a cell phone. In fact, there were no public lines to the States except in Peru’s Ministry of Communication (or some such). To make a call to the States to find out if I could get a job with Ward at the small college, I had first to buy some “telephone stamps.” Then I had to give the “telephone stamps” (pretty things with South American birds on them) to a sort of teller in a window behind bars, and tell them where to call in the States. Then I had to go and sit on an ornate wooden bench that might have been used as a church pew – and I sat for hours. They’d call and it was busy and they would give me my stamps back and then I would give them their stamps back and have them make another call and after a few more hours they said the person was not in. Getting one call through took me three days of stamps and sitting on a hard pew just to get a long distance call through. The world is better now. With all its sins, it is better.

The call went through and David Ward had my job, but I would have to come from Peru to Oklahoma and meet his boss. That meant risking most of the money we had on that plane fare, and leaving Brenda in Lima for several days while I tried to get this only Stateside job that it looked like I could get from here.

Before I left, we did move around Lima, and noted the better eating places (which would not be rife with paramecium, for a change) and observed other peculiarities of the city. Here’s one for the road: At Guzman Blanco plaza, three major highways converged on the world’s fastest roundabout — with the cars going 60 mph. At Guzman Blanco, the two and three-story buildings of Lima were thus on pie-shaped blocks, each coming to a point at the roundabout. To follow one road by foot, the pedestrian would have to cross three major highways at these intersections, just to continue in the same direction. Merely walking there was death-defying, and people waited parts of an hour for traffic to clear enough to cross each highway. So… given this constant, fast-moving traffic, where the buildings’ narrowest points came right up to the roundabout, where would you imagine the Peruvians built their National Institute for the Blind?